NCI Pediatric CIRB Application (Attach 5B)

NIH NCI Central Institutional Review Board (CIRB) Initiative (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0625 can be found here:

Documents and Forms

Document Name Document Type
Form 21 NCI Pediatric CIRB Application (Attach 5B) Form and Instruction
21 NCI Pediatric CIRB Application Attachment 5B - CIRB_Peds_Appl_ 110110.pdf Form and Instruction
21a NCI Pediatric CIRB Application Attach 5B - CIRB Peds_Change with Highlights.pdf Form and Instruction
21a NCI Pediatric CIRB Application Attach 5B - CIRB Peds_NEW.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	NCI Pediatric CIRB Application (Attach 5B)	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	21	NCI Pediatric CIRB Application	Attachment 5B - CIRB_Peds_Appl_ 110110.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	21a	NCI Pediatric CIRB Application	Attach 5B - CIRB Peds_Change with Highlights.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	21a	NCI Pediatric CIRB Application	Attach 5B - CIRB Peds_NEW.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0200 "Clinical, Basic and Population-based Research Studies of the Natonal Institutes of Health (NIH), HHS/NIH/OD"	FR Citation: 67 FR 60776

Number of Respondents: 62	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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	62	62
Annual IC Time Burden (Hours)	124	124
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.