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NDA Data Use Certification (DUC)
NDAR Data Access Request (NIMH)
OMB: 0925-0667
IC ID: 228276
OMB.report
HHS/NIH
OMB 0925-0667
ICR 202110-0925-002
IC 228276
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0667 can be found here:
2023-05-18 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2
NDA Data Use Certification (DUC)
Form and Instruction
2 NDA Data Use Certification
C_NDA Data Use Certification_092520.docx
Form and Instruction
2 NDA Data Use Certification
C_NDA Data Use Certification_092520.docx
Form and Instruction
2 B NDA Data Use Certification revised clean 022421
B_NDA Data Use Certification_Clean 022421.docx
Form and Instruction
2 B NDA Data Use Certification revised clean 022421
B_NDA Data Use Certification_Clean 022421.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NDA Data Use Certification (DUC)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
2
NDA Data Use Certification
C_NDA Data Use Certification_092520.docx
Yes
Yes
Fillable Fileable
Form and Instruction
2
B NDA Data Use Certification revised clean 022421
B_NDA Data Use Certification_Clean 022421.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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:
950
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
950
0
0
0
0
950
Annual IC Time Burden (Hours)
1,425
0
0
0
0
1,425
Annual IC Cost Burden (Dollars)
0
0
0
0
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.