Information Collection

Systems Biology and Physical Sciences Summer Undergraduate Research Program (CSBC/PS-ON SURP) (NCI)

IC 240129 under ICR 202004-0925-001 · OMB 0925-0761.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0761 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Systems Biology and Physical Sciences Summer Undergraduate Research Program (CSBC/PS-ON SURP) (NCI)	Form and Instruction
1 Application Attachment 1 - Application.pdf	Form and Instruction
2 Faculty References Attachment 2 - Faculty References Invitation.pdf	Form and Instruction
Attachment 3 - Privacy Act Memo.pdf Privacy Act Memo	IC Document
Mini SSA Mini Study NCI Systems Biology CSBC PS-ON 2.26.20.docx Sub-study for NCI Systems Biology CSBC PS-ON SURP	IC Document
Attachment 5 - Application Email.pdf application email notification	IC Document

IC Title:

Systems Biology and Physical Sciences Summer Undergraduate Research Program (CSBC/PS-ON SURP) (NCI)

Agency IC Tracking Number:

IC Status: Unchanged

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 and Instruction	1	Application	Attachment 1 - Application.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	2	Faculty References	Attachment 2 - Faculty References Invitation.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-25-0014 Clinical Research: Student Records HHS/NIH/OD/OIR/OE

FR Citation: 67 FR 60742

Number of Respondents: 375

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	375	375
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Privacy Act Memo	Attachment 3 - Privacy Act Memo.pdf	02/27/2020
Sub-study for NCI Systems Biology CSBC PS-ON SURP	Mini SSA Mini Study NCI Systems Biology CSBC PS-ON 2.26.20.docx	02/27/2020
application email notification	Attachment 5 - Application Email.pdf	02/27/2020

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