Information Collection

NCI D43 Grantee

IC 245777 under ICR 202102-0925-004 · OMB 0925-0568.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0568 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 NCI D43 Grantee	Form and Instruction
Form 4 Screenshots of the NCI D43 Grantee NCI D43 Grantee	Form and Instruction
4 Screenshots of the NCI D43 Grantee IV. Sreenshots of the NCI D43 Grantee.docx	Form and Instruction
4 Screenshots of the NCI D43 Grantee IV. Sreenshots of the NCI D43 Grantee.docx	Form and Instruction

IC Title:

NCI D43 Grantee

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	4				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 0925-0014 Clinical Research: Student Records, HHS/NIH/OD/OIR/OE

FR Citation: 67 FR 60742

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	440	440
Annual IC Time Burden (Hours)	293	293
Annual IC Cost Burden (Dollars)	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.

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