Information Collection

NIH Other Transaction Application Form

IC 256274 under ICR 202408-0925-001 · OMB 0925-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NIH Other Transaction Application Form	Form
1 Form Attachment 20A_Other Transaction application form_ASSIST screenshots.pdf	Form
1 Form Attachment 20A_Other Transaction application form_ASSIST screenshots.pdf	Form
2 Form Attachment 20B_ASSIST-Instruction-Guide-for-NIH-Other-Transactions.docx	Form
2 Form Attachment 20B_ASSIST-Instruction-Guide-for-NIH-Other-Transactions.docx	Form

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	1	Form	Attachment 20A_Other Transaction application form_ASSIST screenshots.pdf		Yes	Yes	Fillable Fileable
Form	2	Form	Attachment 20B_ASSIST-Instruction-Guide-for-NIH-Other-Transactions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 239

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	239	239
Annual IC Time Burden (Hours)	2,629	2,629
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.