Information Collection

32105 NIH-OAR ClinicalInfo_Survey_Dec 2021

IC 252336 under ICR 202204-1090-002 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 32105 NIH-OAR Clin 32105 NIH-OAR ClinicalInfo_Survey_Dec 2021	Form and Instruction
32105 NIH-OAR Clin 32105 NIH-OAR ClinicalInfo_Survey_Dec 2021 32105 NIH-OAR ClinicalInfo_Survey_Dec 2021.xlsx	Form and Instruction
32105 NIH-OAR Clin 32105 NIH-OAR ClinicalInfo_Survey_Dec 2021 32105 NIH-OAR ClinicalInfo_Survey_Dec 2021.xlsx	Form and Instruction
1090-0008 Generic Clearance Request Form - NIH OAR Clinical Info survey (002)_signed _ma.pdf 1090-0008 Generic Clearance Request Form - NIH OAR Clinical Info survey (002)_signed _ma	IC Document
1090-0008 Generic Clearance Request Form - NIH OAR Clinical Info survey (002)_signed _ma.pdf 1090-0008 Generic Clearance Request Form - NIH OAR Clinical Info survey (002)_signed _ma	IC Document
1090-0008 Survey Mapping Doc NIH OAR Clinical Info.docx 1090-0008 Survey Mapping Doc NIH OAR Clinical Info	IC Document
1090-0008 Survey Mapping Doc NIH OAR Clinical Info.docx 1090-0008 Survey Mapping Doc NIH OAR Clinical Info	IC Document

IC Title:

32105 NIH-OAR ClinicalInfo_Survey_Dec 2021

Agency IC Tracking Number:

32105 NIH-OAR ClinicalInfo_Survey_Dec 2021

IC Status: Unchanged

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	32105 NIH-OAR ClinicalInfo_Survey_Dec 2021	32105 NIH-OAR ClinicalInfo_Survey_Dec 2021	32105 NIH-OAR ClinicalInfo_Survey_Dec 2021.xlsx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1090-0008 Generic Clearance Request Form - NIH OAR Clinical Info survey (002)_signed _ma	1090-0008 Generic Clearance Request Form - NIH OAR Clinical Info survey (002)_signed _ma.pdf	03/23/2022
1090-0008 Survey Mapping Doc NIH OAR Clinical Info	1090-0008 Survey Mapping Doc NIH OAR Clinical Info.docx	03/23/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.