Information Collection

Data Request Renewal

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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Data Request Renewal	Form
Form 1 Data Request Renewal 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

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	1				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 %

table that charts list of burden
	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

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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