Information Collection

SCHARE Data Repository (SDR) Data Use Oversight System (DUOS)

IC 279178 under ICR 202508-0925-002 · OMB 0925-0775.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Card Issuance SCHARE Data Repository (SDR) Data Use Oversight System (DUOS)	Form
Form 2 Data Access Request SCHARE Data Repository (SDR) Data Use Oversight System (DUOS)	Form
1 Card Issuance Attachment 1-Institutional Signing Official Approval Card Issuance.pdf	Form
2 Data Access Request Attachment 2-Data Access Request.pdf	Form
Attachment 4-Privacy Act SORN.pdf Privacy Act Memo	IC Document
0925-0775-2503 - SCHARE Data Repository Mini SSA.docx Mini SSA	IC Document
Attachment 3-DUOS homepage.pdf HomePage	IC Document

IC Title:

Agency IC Tracking Number:

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
Form	2				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

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	150	150
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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