Information Collection

Data Request Renewal

IC 246754 under ICR 202412-0925-001 · OMB 0925-0744.

Documents and Forms

Document Name Document Type
Form 1 Data Request Renewal Form
1 Data Request Renewal Attachment A.2-9_Data Request Renewal_2024.docx Form
1 Data Request Renewal Attachment A.2-9_Data Request Renewal_2024.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Data Request Renewal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Data Request Renewal	Attachment A.2-9_Data Request Renewal_2024.docx		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/ODâ	FR Citation: 67 FR 60742

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.