Information Collection

IRB Authorization Agreement (COMPLETION)

IC 255040 under ICR 202207-0920-012 · OMB 0920-1366.

Documents and Forms

Document Name Document Type
IRB Authorization Agreement (COMPLETION) Form and Instruction
IRB Authorization Agreement CDC_IRB_Authorization_Agreement_FINAL.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	IRB Authorization Agreement (COMPLETION)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	IRB Authorization Agreement	CDC_IRB_Authorization_Agreement_FINAL.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50,000	50,000
Annual IC Time Burden (Hours)	8,333	8,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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