Information Collection

NIH-AC Exceptional Financial Need (EFN)

IC 265502 under ICR 202503-0925-001 · OMB 0925-0299.

Documents and Forms

Document Name Document Type
Form 1 NIH-AC Exceptional Financial Need (EFN) Form
Form 1 Financial Need NIH-AC Exceptional Financial Need (EFN) Form
1 Financial Need A03-NIHAC-UGSP-Exceptional-Financial-Need.pdf Form
1 Financial Need A03-NIHAC-UGSP-Exceptional-Financial-Need.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NIH-AC Exceptional Financial Need (EFN)	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	Financial Need	A03-NIHAC-UGSP-Exceptional-Financial-Need.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	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	125	125
Annual IC Time Burden (Hours)	21	21
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.

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