Information Collection

SBIR/STTR Funding Agreement Certification

IC 217570 under ICR 202003-0925-003 · OMB 0925-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:

Documents and Forms

Document Name Document Type
Form 27 SBIR/STTR Funding Agreement Certification Form and Instruction
27 SBIR Life Cycle Certification Attachment 16A SBIR-Life-Cycle-Certification_Dec 2019.docx Form and Instruction
28 STTR Life Cycle Certification Attachment 16B STTR Life Cycle Certification_Dec 2019.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SBIR/STTR Funding Agreement Certification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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	27	SBIR Life Cycle Certification	Attachment 16A SBIR-Life-Cycle-Certification_Dec 2019.docx		Yes	Yes	Fillable Fileable
Form and Instruction	28	STTR Life Cycle Certification	Attachment 16B STTR Life Cycle Certification_Dec 2019.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	375	375
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.