Special Volunteer and Guest Researcher Assignment (OD)

Forms and Documents

Document Name	Status
Form 590 Special Volunteers and Guest Researchers Form and Instruction	Removed
Form 3 NIH guest Research Agreement Form	New
Form 2 NIH Special Volunteer Agreement Form	New
Form 590 Special Volunteer and Guest Research Assignment Form and Instruction	New
Form 2 Agreement Form Form	Removed
30-day FRN2017-26966.pdf Supplementary Document	2017-12-14
SSA Attachment 4 - NIH sample letter acknowledging expression of interest.pdf Supplementary Document	2017-11-29
Support_StatementA_for SV-GR form Reinstatement without Change 2017-2020 (2).docx Supporting Statement A	2017-11-29

IC Document Collections

IC ID	Document Title	Status
7250	Special Volunteers and Guest Researchers Form and Instruction	Removed
229194	NIH guest Research Agreement Form	New
229153	NIH Special Volunteer Agreement Form	New
229152	Special Volunteer and Guest Research Assignment Form and Instruction	New
212394	Agreement Form Form	Removed

ICR Details

OMB Control No: 0925-0177	ICR Reference No: 201711-0925-005
Status: Active	Previous ICR Reference No: 201407-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Special Volunteer and Guest Researcher Assignment (OD)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/02/2018
	Date Received in OIRA: 12/14/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved	07/31/2017
Responses	5,740	0	3,320
Time Burden (Hours)	527	0	304
Cost Burden (Dollars)	0	0	0

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Abstract: A single Form NIH-590 is completed by an NIH official for each Guest Researcher or Special Volunteer prior to his/her arrival at NIH. The information on the form is necessary for the approving official to reach a decision on whether to allow a Guest Researcher to use NIH facilities, or whether to accept volunteer services offered by a Special Volunteer. If the original assignment is extended, another form notating the extension is completed to update the file.

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Authorizing Statute(s): US Code: 42 USC 282(b)(10) Name of Law: Public Heath Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 43394	09/15/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 58818	12/14/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Special Volunteer and Guest Research Assignment	590	SV and GR Assignment form
Special Volunteers and Guest Researchers	590	Special Volunteer and Guest Researchers
Agreement Form	1, 2	Guest Researchers Agreement Form ,   Special Volunteer Agreement Form
NIH Special Volunteer Agreement	2	NIH Special Volunteer Agreement
NIH guest Research Agreement	3	NIH Guest Researcher Agreement

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,740	3,320	0	2,420	0	0
Annual Time Burden (Hours)	527	304	0	223	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Reinstatement without change

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Annual Cost to Federal Government: $37,688

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/14/2017

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