Information Collection

Private sector

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

Documents and Forms

Documents and forms in this information collection
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

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:

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
Form	1				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 %

table that charts list of burden
	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

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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