Information Collection

Private sector

IC 252166 under ICR 202507-0925-001 · OMB 0925-0689.

Documents and Forms

Document Name Document Type
Form 1 Private sector Form
Form 1 Application Private sector Form
Form 1 Form Private sector Form
1 Application Attachment 1 - NIH Certificate of Confidentiality (CoC) Request Form Screenshots.docx Form
1 Application Attachment 1 - NIH Certificate of Confidentiality (CoC) Request Form Screenshots.docx Form
1 Form Assurance statement Feb 2025.docx Form
1 Form Assurance statement Feb 2025.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Private sector	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Application	Attachment 1 - NIH Certificate of Confidentiality (CoC) Request Form Screenshots.docx		Yes	Yes	Fillable Fileable
Form	1	Form	Assurance statement Feb 2025.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0225, NIH Electronic Research Administration (eRA) Records, HHS/NIH/OD/OER	FR Citation: 67 FR 67042

Number of Respondents: 865	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	865	865
Annual IC Time Burden (Hours)	1,298	1,298
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].