Information Collection Request

Specimen Resource Location (SRL) NCI

ICR 202306-0925-001 · OMB 0925-0703 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Initial Request Form Modified Available
Form 1 Federal Government Annual Update Form Modified Repair queued
Form 1 Initial Request Form Modified Available
Form 1 State Government Annual Update Form Modified Repair queued
Form 1 Initial Request Form Modified Available
Form 1 Private Sector Annual Update Form Modified Repair queued
Form 1 Initial Request Form Modified Available
Form 1 Federal Government Initial Request Form Modified Repair queued
Form 1 Initial Request Form Modified Available
Form 1 State Government Initial Request Form Modified Repair queued
Form 1 Initial Request Form Modified Available
Form 1 Private Sector Initial Request Form Modified Repair queued
A1 - Invitation Letter (1).docx Supplementary Document Uploaded 2023-06-23 Repair queued
A3 - Annual Update Email.docx Supplementary Document Uploaded 2023-06-23 Repair queued
A4 - NCI SRL Privacy Act Memo 2023 signed.pdf Supplementary Document Uploaded 2023-06-23 Repair queued
SSA - SRL - Extension 6.8.2023 (1).docx Supporting Statement A Uploaded 2023-06-23 Repair queued
SRL 30day notice.pdf Supplementary Document Uploaded 2023-06-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228621 Federal Government Annual Update Form ModifiedInitial Request
228621 Federal Government Annual Update Form Modified
228620 State Government Annual Update Form ModifiedInitial Request
228620 State Government Annual Update Form Modified
228619 Private Sector Annual Update Form ModifiedInitial Request
228619 Private Sector Annual Update Form Modified
228618 Federal Government Initial Request Form ModifiedInitial Request
228618 Federal Government Initial Request Form Modified
228617 State Government Initial Request Form ModifiedInitial Request
228617 State Government Initial Request Form Modified
228616 Private Sector Initial Request Form ModifiedInitial Request
228616 Private Sector Initial Request Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2026 36 Months From Approved 11/30/2023
250 0 250
105 0 105
0 0 0





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
Federal Government Annual Update 1
Federal Government Initial Request 1
Private Sector Annual Update 1
Private Sector Initial Request 1
State Government Annual Update 1
State Government Initial Request 1

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 250 250 0 0 0 0
Annual Time Burden (Hours) 105 105 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No