Information Collection

Follow-up Form (Attachment D05)

IC 229999 under ICR 202411-0925-001 · OMB 0925-0753.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 88 Follow-up Form (Attachment D05)	Form
Form 88 Follow up Follow-up Form (Attachment D05)	Form
88 Follow up CTMBAIS_Attachment_D05_Follow_Up.pdf	Form
88 Follow up CTMBAIS_Attachment_D05_Follow_Up.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	88				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Clinical, Basic and Population-based Research Studies of the National Institutes of Health (NIH)

FR Citation: 67 FR 60742

Number of Respondents: 44

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	308	308
Annual IC Time Burden (Hours)	139	139
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.

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