US Core Data for Interoperability (USCDI) New Data Element Submission Form

US Core Data for Interoperability New Data Element Submission Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0955-0020 can be found here:

Documents and Forms

Document Name Document Type
Form 1 US Core Data for Interoperability (USCDI) New Data Element Submission Form Form
1 USCDI Submission Form USCDI New Submission Form.docx Form

Information Collection (IC) Details

IC Title:	US Core Data for Interoperability (USCDI) New Data Element Submission Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.5 (b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	USCDI Submission Form	USCDI New Submission Form.docx		Yes	No	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	33	33
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.