NCI/DCTD/CTEP Financial Disclosure Form (Attachment E03)

CTEP Branch Support Contracts Forms and Surveys (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0753 can be found here:

Documents and Forms

Document Name Document Type
Form 93 NCI/DCTD/CTEP Financial Disclosure Form (Attachment E03) Form
93 Fin Disclosure PMB_Attachment_E03_CTEP_Fin_Disclos.pdf Form
1 Financial Disclosure Revised PMB Attachment E03 CTEP Fin Disclos.pdf Form

Information Collection (IC) Details

IC Title:	NCI/DCTD/CTEP Financial Disclosure Form (Attachment E03)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	93	Fin Disclosure	PMB_Attachment_E03_CTEP_Fin_Disclos.pdf		Yes	Yes	Fillable Fileable
Form	1	Financial Disclosure	Revised PMB Attachment E03 CTEP Fin Disclos.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Clinical, Basic and Population-based Research Studies of the National Institutes of Health (NIH)	FR Citation: 67 FR 60742

Number of Respondents: 33,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	33,000	33,000
Annual IC Time Burden (Hours)	2,750	2,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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