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Health Disparities Research Institute (HDRI) (NIMHD)
Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)
OMB: 0925-0740
IC ID: 249446
OMB.report
HHS/NIH
OMB 0925-0740
ICR 202201-0925-002
IC 249446
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:
2022-10-19 - No material or nonsubstantive change to a currently approved collection
2022-08-04 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form 1
Health Disparities Research Institute (HDRI) (NIMHD)
Form
1 2022HDRI application form
2022 HDRI FINAL application form clean version.docx
Form
1 2022HDRI application form
2022 HDRI FINAL application form clean version.docx
Form
2021HD_1 (1).docx
email invite
IC Document
2021HD_1 (1).docx
email invite
IC Document
2022HD_2.docx
sub-study Health Disparities Research Institute (HDRI)
IC Document
2022HD_2.docx
sub-study Health Disparities Research Institute (HDRI)
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Health Disparities Research Institute (HDRI) (NIMHD)
Agency IC Tracking Number:
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
1
2022HDRI application form
2022 HDRI FINAL application form clean version.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:
FR Citation:
Number of Respondents:
250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
250
0
0
0
0
250
Annual IC Time Burden (Hours)
104
0
0
0
0
104
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
email invite
2021HD_1 (1).docx
09/22/2021
sub-study Health Disparities Research Institute (HDRI)
2022HD_2.docx
09/22/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.