Subpart C Research Certification Form

Documents and Forms

Document Name Document Type
Form 0990-0473 Subpart C Research Certification Form Form
0990-0473 HHS Subpart C Certification Form HHS Subpart C Certification Form .pdf oashsps.my.site.com/ohrpwebforms/s/prisoner-web-form Form
0990-0473 HHS Subpart C Certification Form HHS Subpart C Certification Form .pdf oashsps.my.site.com/ohrpwebforms/s/prisoner-web-form Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Subpart C Research Certification Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 46 45 CFR 46.306(a)(2) 45 CFR 46.305(a) 45 CFR 46.305(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0990-0473	HHS Subpart C Certification Form	HHS Subpart C Certification Form .pdf	https://oashsps.my.site.com/ohrpwebforms/s/prisoner-web-form	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50	-30	80
Annual IC Time Burden (Hours)	50	-30	80
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.