Information Collection

NDA Data Submission Agreement (DSA)

IC 228274 under ICR 202606-0925-001 · OMB 0925-0667.

Documents and Forms

Document Name Document Type
Form 1 Submission Agreement NDA Data Submission Agreement (DSA) Form and Instruction
1 Submission Agreement NIMH Data Archive Submission Agreement_04.10.26.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NDA Data Submission Agreement (DSA)	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 and Instruction	1	Submission Agreement	NIMH Data Archive Submission Agreement_04.10.26.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD	FR Citation: 67 FR 60742

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	450	450
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.

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