Information Collection

Data and Safety Monitoring Meeting Evaluation (NIAMS)

IC 244865 under ICR 201906-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Data and Safety Monitoring Meeting Evaluation (NIAMS)	Form
1 NCR MB Survey screenshot NCR_MB Survey_Screenshots_2020_12_10.docx	Form
KAI_Fast Track Template_2020_12_10_Updated.docx fast track survey for NCR MB	IC Document

IC Title:

Data and Safety Monitoring Meeting Evaluation (NIAMS)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	NCR MB Survey screenshot	NCR_MB Survey_Screenshots_2020_12_10.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track survey for NCR MB	KAI_Fast Track Template_2020_12_10_Updated.docx	12/10/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.