Information Collection

Electronic Agent Accountability Record Form (eDARF)

IC 250487 under ICR 202409-0925-001 · OMB 0925-0613.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Electronic Agent Accountability Record Form (eDARF)	Form
1 A3: Electronic Agent Accountability Record Form (eDARF) Attachment 3 - Electronic Agent Accountability Record Form.pdf	Form
1 A3: Electronic Agent Accountability Record Form (eDARF) Attachment 3 - Electronic Agent Accountability Record Form.pdf	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	A3: Electronic Agent Accountability Record Form (eDARF)	Attachment 3 - Electronic Agent Accountability Record Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-25-0200, âClinical, Basic and Population-based Research Studies of the National Institutes of Health (NIH) HHS/NIH/OD,

FR Citation: 67 FR 60776

Number of Respondents: 2,500

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50,000	34,800	15,200
Annual IC Time Burden (Hours)	833	580	253
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.