OMB control number

Assurance (Interinstitutional, Foreign, and Domestic) and Annual Report (Office of Director)

OMB 0925-0765 · HHS/NIH.

OMB 0925-0765

The Office of Laboratory Animal Welfare (OLAW), Office of Extramural Research, Office of the Director, National Institutes of Health (NIH) is requesting approval for a reinstatement with change for the information collection requirements of the Paperwork Reduction Act of 1995. The purpose of the Assurance (Interinstitutional, Foreign, and Domestic) and Annual Report is to provide OLAW with documentation to satisfy the requirements of the Health Research Extension Act (HREA) of 1985 (Public Law 99-158 section 495 as codified in 42 U.S.C. 289d), illustrate institutional adherence to Public Health Service (PHS) Policy on Humane Care and Use of Laboratory Animals (Policy), and enable OLAW to carry out its mission to ensure the humane care and use of animals in PHS-supported research, testing, and training, thereby contributing to the quality of PHS-supported activities. Office of Management and Budget (OMB) approval is requested for 3 years.

The latest form for Assurance (Interinstitutional, Foreign, and Domestic) and Annual Report (Office of Director) expires 2027-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 8 Interinstitutional Assurance Triad for Domestic Performance Site Form and Instruction
Form 7 Interinstitutional Assurance for Domestic Performance Site Form and Instruction
Form 7 Interinstitutional Assurance for Domestic Performance Site or Interinstitutional Assurance Triad for Domestic Performance Site Form and Instruction
Form 6 Interinstitutional Assurance Triad for Foreign Performance Site Form and Instruction
Form 5 Interinstitutional Assurance for Foreign Performance Site Form and Instruction
Form 5 Interinstitutional Assurance for Foreign Performance Site or Interinstitutional Assurance Triad for Foreign Performance Site Form and Instruction
Form 1 Annual Report Form and Instruction
Form 1 Foreign Annual Report Form and Instruction
Form 3 Foreign Assurance Form and Instruction
Form 3 Foreign Assurance Renewal and New Form and Instruction
Form 2 Domestic Annual Report Form and Instruction
Form 2 Domestic Annual Report Form and Instruction
Form 1 Domestic Assurance Form and Instruction
Form 1 Domestic Assurance Form and Instruction
Foreign Annual Report Tracked Changes.docx Supplementary Document
Foreign Annual Report Tracked Changes.docx Supplementary Document
Change Memo Foreign Annual Report Form.pdf Justification for No Material/Nonsubstantive Change
OD 30 day notice.pdf Supplementary Document
OD 30 day notice.pdf Supplementary Document
OD Support_Statement_A revised 2024-01-09.docx Supporting Statement A
Interinstitutional Assurance for Domestic Performance Site or Interinstitutional Assurance Triad for Domestic Performance Site Form and Instruction
Interinstitutional Assurance for Domestic Performance Site or Interinstitutional Assurance Triad for Domestic Performance Site Form and Instruction
Interinstitutional Assurance for Domestic Performance Site or Interinstitutional Assurance Triad for Domestic Performance Site Form and Instruction
Interinstitutional Assurance for Foreign Performance Site or Interinstitutional Assurance Triad for Foreign Performance Site Form and Instruction
Interinstitutional Assurance for Foreign Performance Site or Interinstitutional Assurance Triad for Foreign Performance Site Form and Instruction
Interinstitutional Assurance for Foreign Performance Site or Interinstitutional Assurance Triad for Foreign Performance Site Form and Instruction
Foreign Annual Report Form and Instruction
Foreign Annual Report Form and Instruction
Foreign Assurance Renewal and New Form and Instruction
Foreign Assurance Renewal and New Form and Instruction
Domestic Annual Report Form and Instruction
Domestic Annual Report Form and Instruction
Domestic Assurance Form and Instruction
Domestic Assurance Form and Instruction

All Historical Document Collections

202506-0925-002 Approved with change	No material or nonsubstantive change to a currently approved collection	2025-06-30
202310-0925-002 Approved with change	Reinstatement with change of a previously approved collection	2023-12-06
202002-0925-004 Approved with change	No material or nonsubstantive change to a currently approved collection	2020-02-06
201909-0925-002 Approved without change	New collection (Request for a new OMB Control Number)	2019-09-12

OMB Details

Domestic Assurance

Federal Enterprise Architecture: Health - Health Care Services

Form 1

Domestic Assurance

Printable Only

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.