Information Collection

Renewal or Close-out (Principal Investigator)

IC 279279 under ICR 202508-0925-001 · OMB 0925-0670.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Legacy System – Authorized Access Renewal or Close-out (Principal Investigator)	Form
Form 1 Legacy System – Authorized Access Renewal or Close-out (Principal Investigator)	Form
1 Legacy System – Authorized Access Attachment 5 - Legacy System - Authorized Access.pptx	Form
1 Legacy System – Authorized Access Attachment 5 - Legacy System - Authorized Access.pptx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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:

FR Citation:

Number of Respondents: 281

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	1,124	1,124
Annual IC Time Burden (Hours)	281	281
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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