Information Collection

NIAID ClinRegs Country Specific SME Interest Form (NIAID)

IC 243478 under ICR 202003-0925-002 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NIAID ClinRegs Country Specific SME Interest Form (NIAID)	Form
1 SME Interest form SME-form-with-burden-statement-updated.pdf	Form
ClinRegs SME Interest Form template.docx sub study request for NIAID ClinRegs SME Interest form	IC Document
NIAID ClinRegs SORN.pdf Privacy Act Memo	IC Document
NIAID ClinRegs_PIA (1).docx PIA	IC Document

IC Title:

NIAID ClinRegs Country Specific SME Interest Form (NIAID)

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	SME Interest form	SME-form-with-burden-statement-updated.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-90-1802, âHHS Correspondence, Customer Service, and Contact List Records.

FR Citation: 69 FR 71414

Number of Respondents: 50

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub study request for NIAID ClinRegs SME Interest form	ClinRegs SME Interest Form template.docx	09/03/2020
Privacy Act Memo	NIAID ClinRegs SORN.pdf	09/03/2020
PIA	NIAID ClinRegs_PIA (1).docx	09/03/2020

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