Information Collection

Clinical Electives Program (CEP

IC 226823 under ICR 202308-0925-002 · OMB 0925-0698.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Clinical Electives Program (CEP	Form and Instruction
1 Application Attachment 1_Clinical Electives Program.pdf	Form and Instruction
1 Application Attachment 1_Clinical Electives Program.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Application	Attachment 1_Clinical Electives Program.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Clinical Research: Student Records, HHS/NIH/OD/OIR/OE

FR Citation: 67 FR 60741

Number of Respondents: 300

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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.