Information Collection Request

NDAR Data Access Request (NIMH)

ICR 202305-0925-002 · OMB 0925-0667 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 2 Certification Form and Instruction Modified Available
Form 2 NDA Data Use Certification (DUC) Form and Instruction Modified Repair queued
Form 1 Submission Agreement Form and Instruction Modified Available
Form 1 NDA Data Submission Agreement (DSA) Form and Instruction Modified Repair queued
0925-0667.SSA.REVISION.NIMH Data Archive_05.09.23.docx Supporting Statement A Uploaded 2023-05-18 Repair queued
A_Privacy Impact Assessment-NIH NIMH NDA.pdf Supplementary Document Uploaded 2023-05-18 Repair queued
D_NDA Consult List.docx Supplementary Document Uploaded 2023-05-17 Repair queued
30-day notice 0667.pdf Supplementary Document Uploaded 2023-05-17 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228276 NDA Data Use Certification (DUC) Form and Instruction ModifiedCertification
228276 NDA Data Use Certification (DUC) Form and Instruction Modified
228274 NDA Data Submission Agreement (DSA) Form and Instruction ModifiedSubmission Agreement
228274 NDA Data Submission Agreement (DSA) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2026 36 Months From Approved 01/31/2024
1,250 0 1,250
1,875 0 1,875
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
NDA Data Submission Agreement (DSA) 1
NDA Data Use Certification (DUC) 2

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 1,250 1,250 0 0 0 0
Annual Time Burden (Hours) 1,875 1,875 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No