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Systems Biology and Physical Sciences Summer Undergraduate Research Program (CSBC/PS-ON SURP) (NCI)
Generic Clearance for Application Information for Fellowships, Internships, Training Programs, and Specialty Positions (NCI)
OMB: 0925-0761
IC ID: 240129
OMB.report
HHS/NIH
OMB 0925-0761
ICR 202004-0925-001
IC 240129
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0761 can be found here:
2022-05-31 - Extension without change of a currently approved collection
Documents and Forms
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
Information Collection (IC) Details
View Information Collection (IC)
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:
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
Federal Enterprise Architecture Business Reference Module
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 %
Requested
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
375
0
0
0
0
375
Annual IC Time Burden (Hours)
250
0
0
0
0
250
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.