Application Forms for the NIDA Summer Research Internship Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Student Application Form	Form and Instruction	Modified	Available
Form 1 Student Application Form	Form and Instruction	Modified	Repair queued
pub 30day FRN2022-27990.pdf	Supplementary Document	Uploaded 2022-12-27	Repair queued
Support Statement A NIDA Summer Research Internship REVISED (2).docx	Supporting Statement A	Uploaded 2022-12-19	Repair queued
Attachment 3 - HHS Privacy Impact Assessment (PIA).pdf	Supplementary Document	Uploaded 2022-12-19	Repair queued
Attachment 2 - NIDA SRIP Privacy Act Memo.pdf	Supplementary Document	Uploaded 2022-12-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238310	Student Application Form	Form and Instruction	Modified	Student Application Form
238310	Student Application Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0925-0738	ICR Reference No: 202212-0925-003
Status: Historical Active	Previous ICR Reference No: 201910-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Application Forms for the NIDA Summer Research Internship Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/22/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/27/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2026	36 Months From Approved	02/28/2023
Responses	300	0	250
Time Burden (Hours)	300	0	250
Cost Burden (Dollars)	0	0	0

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Abstract: The National Institute on Drug Abuse (NIDA), the National Institutes of Health (NIH), is submitting an extension of a previously approved submission for the application forms for the NIDA Summer Research Internship Program

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Authorizing Statute(s): US Code: 42 USC sections 241 and 282(b)(13) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 64068	10/21/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 78987	12/23/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Student Application Form	1	Student Application Form

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ICR Summary of Burden

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	300	250	0	50	0	0
Annual Time Burden (Hours)	300	250	0	50	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There are no program changes. Based on the number of respondents applying in the last few years, the estimated number of respondents increased from 250 to 300.

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Annual Cost to Federal Government: $96,004

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/27/2022

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