Information Collection Request
Electronic Application for NIH Certificates of Confidentiality (CoC E-application System)
ICR 202405-0925-003 · OMB 0925-0689 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0925-0689 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 1 Private sector |
Form and Instruction | Modified | Repair queued |
| Form 1 Private sector |
Form and Instruction | Modified | Repair queued |
 Attachment 1 Updated assurance statement May 2024.docx |
Supplementary Document | Uploaded 2024-05-27 | Repair queued |
| Attachment 1 Updated assurance statement May 2024.docx |
Supplementary Document | Uploaded 2024-05-27 | Repair queued |
 OMB change request May 2024.signed.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-05-27 | Available |
| OMB change request May 2024.signed.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-05-27 | Repair queued |
| Revised assurance statement SEP2023.clean.docx |
Supplementary Document | Uploaded 2023-10-05 | Repair queued |
| Revised assurance statement SEP2023.clean.docx |
Supplementary Document | Uploaded 2023-10-05 | Repair queued |
| Markup assurance statement SEP2023.pdf |
Supplementary Document | Uploaded 2023-10-05 | Repair queued |
| Markup assurance statement SEP2023.pdf |
Supplementary Document | Uploaded 2023-10-05 | Repair queued |
| OMB change request SEP 2023.1signed.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-10-04 | Available |
| OMB change request SEP 2023.1signed.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-10-04 | Missing upstream |
| Updated assurance statement 06022023.pdf |
Supplementary Document | Uploaded 2023-06-15 | Available |
| Updated assurance statement 06022023.pdf |
Supplementary Document | Uploaded 2023-06-15 | Repair queued |
| OMB change request JUN 2023.pk.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-06-15 | Available |
| OMB change request JUN 2023.pk.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-06-15 | Repair queued |
| Change Request Memo.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-10-13 | Repair queued |
| Change Request Memo.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-10-13 | Missing upstream |
| pub 30day FRN2022-05474.pdf |
Supplementary Document | Uploaded 2022-03-15 | Available |
| pub 30day FRN2022-05474.pdf |
Supplementary Document | Uploaded 2022-03-15 | Repair queued |
| Attachment 2 - List of DHHS CoC Coordinators.docx |
Supplementary Document | Uploaded 2022-03-14 | Repair queued |
| Attachment 2 - List of DHHS CoC Coordinators.docx |
Supplementary Document | Uploaded 2022-03-14 | Repair queued |
| CoC Support_StatementA_FINAL_MAR2022.docx |
Supporting Statement A | Uploaded 2022-03-14 | Repair queued |
| CoC Support_StatementA_FINAL_MAR2022.docx |
Supporting Statement A | Uploaded 2022-03-14 | Repair queued |
| Attachment 3 - Privacy Impact Assessment (PIA) NOV 2021.pdf |
Supplementary Document | Uploaded 2022-03-14 | Repair queued |
| Attachment 3 - Privacy Impact Assessment (PIA) NOV 2021.pdf |
Supplementary Document | Uploaded 2022-03-14 | Repair queued |
| Attachment 4 - NIH Privacy Act Memo Applicability of the Privacy Act_CoC_FEB 2022.pdf |
Supplementary Document | Uploaded 2022-03-14 | Available |
| Attachment 4 - NIH Privacy Act Memo Applicability of the Privacy Act_CoC_FEB 2022.pdf |
Supplementary Document | Uploaded 2022-03-14 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 252166 |  Private sector |
Form and Instruction | Modified | |
| 252166 | Private sector |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/NIH |
| OMB Control No | 0925-0689 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202310-0925-001 |
| Agency Tracking No | 20936 |
| Date Submitted to OIRA | 2024-05-28 |
| Requested Expiration Date | 1969-12-31 |