Information Collection Request

Special Volunteer and Guest Researcher Assignment (OD)

ICR 202512-0925-003 · OMB 0925-0177 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Agreement Form Modified Repair queued
Form 1 NIH Guest Research Agreement Form Modified Repair queued
Form 1 Agreement Form Modified Repair queued
Form 1 NIH Special Volunteer Agreement Form Modified Repair queued
Form 1 Assignment Form Modified Repair queued
Form 1 Special Volunteer and Guest Research Assignment Form Modified Repair queued
30day 0177.pdf Supplementary Document Uploaded 2025-12-18 Repair queued
30day 0177.pdf Supplementary Document Uploaded 2025-12-18 Repair queued
SSA for Extension of SV-GR Assignment.docx Supporting Statement A Uploaded 2025-12-17 Repair queued
SSA for Extension of SV-GR Assignment.docx Supporting Statement A Uploaded 2025-12-17 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
229194 NIH Guest Research Agreement Form ModifiedAgreement
229194 NIH Guest Research Agreement Form Modified
229153 NIH Special Volunteer Agreement Form ModifiedAgreement
229153 NIH Special Volunteer Agreement Form Modified
229152 Special Volunteer and Guest Research Assignment Form ModifiedAssignment
229152 Special Volunteer and Guest Research Assignment Form Modified
ICR Details
0925-0177 202512-0925-003
Active 202212-0925-002
HHS/NIH
Special Volunteer and Guest Researcher Assignment (OD)
Extension without change of a currently approved collection   No
Regular
Approved without change 01/21/2026
Retrieve Notice of Action (NOA) 12/19/2025
  Inventory as of this Action Requested Previously Approved
01/31/2029 36 Months From Approved 03/31/2026
6,900 0 6,900
652 0 652
0 0 0

This is an extension request (no revisions) of an approved collection, OMB Control #0925-0177, with an expiration date of 03/31/2026. Because data required for these two Programs are similar, a consolidated Form NIH-590 is used (See Attachment 1, no revision requested). This form number and the data collected has not changed from the last approval cycle.

US Code: 42 USC 282(b)(10) Name of Law: Public Heath Service Act
   US Code: 42 USC 284 (b) (1) (K) Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  90 FR 46230 09/25/2025
90 FR 59135 12/18/2025
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,900 6,900 0 0 0 0
Annual Time Burden (Hours) 652 652 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$47,939
No
    Yes
    Yes
No
No
No
No
Mikia Currie 3014350941

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/19/2025