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Adult amendment of Cooperative Group Protocol (Attachment B19)
CTEP Branch Support Contracts Forms and Surveys (NCI)
OMB: 0925-0753
IC ID: 225889
OMB.report
HHS/NIH
OMB 0925-0753
ICR 201908-0925-003
IC 225889
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0753 can be found here:
2024-11-12 - No material or nonsubstantive change to a currently approved collection
2024-08-29 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 35
Adult amendment of Cooperative Group Protocol (Attachment B19)
Form and Instruction
35 Adult AR FB Reviewer Worksheet
att_B19 - Adult - AR_FB_Reviewer Worksheet_v081916.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Adult amendment of Cooperative Group Protocol (Attachment B19)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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 and Instruction
35
Adult AR FB Reviewer Worksheet
att_B19 - Adult - AR_FB_Reviewer Worksheet_v081916.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Clinical Basic and Population-based Research Studies of the National Institutes of Health
FR Citation:
67 FR 60742
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40
0
0
0
0
40
Annual IC Time Burden (Hours)
80
0
0
0
0
80
Annual IC Cost Burden (Dollars)
0
0
0
0
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.