Information Collection

Resident Elective Program (REP)

IC 226824 under ICR 202006-0925-001 · OMB 0925-0698.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0698 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 Resident Elective Program (REP)	Form
4 Resident Electives Program Attachment 4_Resident Electives Program (1).pdf	Form

IC Title:

Resident Elective Program (REP)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	4	Resident Electives Program	Attachment 4_Resident Electives Program (1).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Clinical Research: Student Records

FR Citation: 67 FR 60741

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	10	90
Annual IC Time Burden (Hours)	33	3	30
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.