Information Collection

CoC Applicants - Federal

IC 238764 under ICR 202203-0925-001 · OMB 0925-0689.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0689 can be found here:

2025-07-08 - Reinstatement without change of a previously approved collection
2024-11-13 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 CoC Applicants - Federal	Form and Instruction
1 NIH Certificates of Confidentiality Request Form Screens CoC v3_with burden disclosure revised with changes highlighted 030320.pdf	Form and Instruction
1 NIH Certificates of Confidentiality Request Form Screens CoC v3_with burden disclosure revised with changes highlighted 030320.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

CoC Applicants - Federal

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	1	NIH Certificates of Confidentiality Request Form Screenshots	CoC v3_with burden disclosure revised with changes highlighted 030320.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: NIH Privacy Act Systems of Record 09-25-0156, âRecords of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD

FR Citation: 67 FR 60742

Number of Respondents: 78

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-78	78
Annual IC Time Burden (Hours)	-117	117
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.