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INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
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TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
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| Peer Review Related Forms for the Office of Scientific Quality Review |
0518-0028 |
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| DATE PREPARED |
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TOTAL |
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FORMS NO (S) |
NO. OF |
NO OF |
TOTAL ANNUAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
RECORD- |
| SECTION OF |
DESCRIPTION |
(If "none" |
RESPONDENTS |
RESPONSES |
RESPONSES |
PER |
HOURS |
RECORD- |
HOURS PER |
KEEPING HOURS |
| REGS. |
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so state) |
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PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
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RESPONDENT |
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KEEPER |
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| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
| PL 105-85, Sec. 103d & Fed. Advisory Comm. Act |
Panel Recommendations Form |
ARS-223P |
82 |
2 |
164 |
2 |
328 |
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| PL 105-85, Sec. 103d & Fed. Advisory Comm. Act |
Peer Review Form |
ARS-225P |
200 |
2 |
400 |
5 |
2000 |
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| PL 105-85, Sec. 103d |
Expense Form OSQR |
ARS-209P |
6 |
1 |
6 |
0.5 |
3 |
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| PL 105-85, Sec. 103d |
Confidentiality and Conflict of Interest Form |
ARS-200PA |
185 |
1 |
185 |
0.1666 |
30.8 |
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| PL 105-85, Sec. 103d |
Panelist Information Form |
ARS-202P |
185 |
1 |
185 |
0.5 |
92.5 |
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| PL 105-85, Sec. 103d |
Reviewer Comment Form |
ARS-231 |
6 |
2 |
12 |
0.5 |
6 |
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SUBTOTAL |
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952 |
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2460.3 |
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