NIH Other Transaction Application Form

PHS Applications and Pre-award Related Reporting (OD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NIH Other Transaction Application Form Form and Instruction
1 Other Transaction Application Form Screenshots Attachment 20A_Other Transaction application form_ASSIST screenshots 0001.pdf Form and Instruction
1 Other Transaction Application Form Screenshots Attachment 20A_Other Transaction application form_ASSIST screenshots 0001.pdf Form and Instruction
Attachment 20B_Other Transaction_ASSIST user instruction guide.docx Other Transactions Application Form Instructions IC Document
Attachment 20B_Other Transaction_ASSIST user instruction guide.docx Other Transactions Application Form Instructions IC Document

Information Collection (IC) Details

IC Title:	NIH Other Transaction Application Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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	1	Other Transaction Application Form Screenshots	Attachment 20A_Other Transaction application form_ASSIST screenshots 0001.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 239	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	239	239
Annual IC Time Burden (Hours)	2,629	2,629
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Other Transactions Application Form Instructions	Attachment 20B_Other Transaction_ASSIST user instruction guide.docx	10/05/2022

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