Information Collection

Protection of Human Subjects Assurance Identification/IRB Certification/Declaration of Exemption

IC 10393 under ICR 202404-0990-001 · OMB 0990-0263.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0990-0263 Protection of Human Subjects Assurance Identification/IRB Certification/Declaration of Exemption	Form
0990-0263 Protection of Human Subjects: Assurance Identification/I Protection of Human Subjects Assurance Identification_IRB Certification_Declaration of Exemption (Common Rule) Form.docx	Form
0990-0263 Protection of Human Subjects: Assurance Identification/I Protection of Human Subjects Assurance Identification_IRB Certification_Declaration of Exemption (Common Rule) Form.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	0990-0263	Protection of Human Subjects: Assurance Identification/IRB Certification/ Declaration of Exemption Form	Protection of Human Subjects Assurance Identification_IRB Certification_Declaration of Exemption (Common Rule) Form.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,000

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	26,000	-2,000	28,000
Annual IC Time Burden (Hours)	13,000	-1,000	14,000
Annual IC Cost Burden (Dollars)	0	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.