NCI/DCTD/CTEP Financial Disclosure Form (Attachment E03)

CTEP Branch Support Contracts Forms and Surveys (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0753 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NCI/DCTD/CTEP Financial Disclosure Form (Attachment E03) Form
1 Financial Disclosure PMB_Attachment_E03_FDF.pdf Form
1 Financial Disclosure PMB_Attachment_E03_FDF.pdf Form

Information Collection (IC) Details

IC Title:	NCI/DCTD/CTEP Financial Disclosure Form (Attachment E03)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Financial Disclosure	PMB_Attachment_E03_FDF.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Clinical, Basic and Population-based Research Studies of the National Institutes of Health (NIH)	FR Citation: 67 FR 60742

Number of Respondents: 48,000	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 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	48,000	15,000	33,000
Annual IC Time Burden (Hours)	12,000	9,250	2,750
Annual IC Cost Burden (Dollars)	0	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.