Information Collection Request

Electronic Application for NIH Certificates of Confidentialty (CoC E-application System)

ICR 202203-0925-001 · OMB 0925-0689 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Certification of Confidentiality Form and Instruction New Available
Form 1 Private sector Form and Instruction New Repair queued
Form 1 NIH Certificates of Confidentiality Request Form Screenshots Form and Instruction Removed Available
Form 1 CoC Applicants - Federal Form and Instruction Removed Repair queued
Form 1 NIH Certificate of Confidentiality Request Form Screenshot Form and Instruction Removed Available
Form 1 CoC Applicants - Small Business Form and Instruction Removed Repair queued
Form 1 NIH Certificates of Confidentiality Request Form Screenshots Form and Instruction Removed Available
Form 1 CoC Applicants - State/local Form and Instruction Removed Repair queued
Form 1 NIH Certificates of Confidentiality Request Form Screenshot Form and Instruction Removed Repair queued
Form 1 CoC Applications - Private Form and Instruction Removed Repair queued
pub 30day FRN2022-05474.pdf Supplementary Document Uploaded 2022-03-15 Repair queued
Attachment 2 - List of DHHS CoC Coordinators.docx Supplementary Document Uploaded 2022-03-14 Repair queued
CoC Support_StatementA_FINAL_MAR2022.docx Supporting Statement A Uploaded 2022-03-14 Repair queued
Attachment 3 - Privacy Impact Assessment (PIA) NOV 2021.pdf Supplementary Document Uploaded 2022-03-14 Repair queued
Attachment 4 - NIH Privacy Act Memo Applicability of the Privacy Act_CoC_FEB 2022.pdf Supplementary Document Uploaded 2022-03-14 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
252166 Private sector Form and Instruction NewCertification of Confidentiality
252166 Private sector Form and Instruction New
238764 CoC Applicants - Federal Form and Instruction RemovedNIH Certificates of Confidentiality Request Form Screenshots
238764 CoC Applicants - Federal Form and Instruction Removed
238763 CoC Applicants - Small Business Form and Instruction RemovedNIH Certificate of Confidentiality Request Form Screenshot
238763 CoC Applicants - Small Business Form and Instruction Removed
238762 CoC Applicants - State/local Form and Instruction RemovedNIH Certificates of Confidentiality Request Form Screenshots
238762 CoC Applicants - State/local Form and Instruction Removed
238761 CoC Applications - Private Form and Instruction RemovedNIH Certificates of Confidentiality Request Form Screenshot
238761 CoC Applications - Private Form and Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2025 36 Months From Approved 02/28/2023
795 0 529
1,193 0 794
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
CoC Applicants - Federal 1
CoC Applicants - Small Business 1
CoC Applicants - State/local 1
CoC Applications - Private 1
Private sector 1

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 795 529 0 266 0 0
Annual Time Burden (Hours) 1,193 794 0 399 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No