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Review Worksheet CIRB Review for Inclusion of Incarcerated Participants (Attachment B48)
CTEP Branch Support Contracts Forms and Surveys (NCI)
OMB: 0925-0753
IC ID: 245474
OMB.report
HHS/NIH
OMB 0925-0753
ICR 202402-0925-001
IC 245474
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0753 can be found here:
2024-11-12 - No material or nonsubstantive change to a currently approved collection
2024-08-29 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 96
Review Worksheet CIRB Review for Inclusion of Incarcerated Participants (Attachment B48)
Form and Instruction
96 Attachment B48 Prisoner FB Reviewer Worksheet
Attachment_B48_Prisoner_FB_ReviewerWksht.pdf
Form and Instruction
96 Attachment B48 Prisoner FB Reviewer Worksheet
Attachment_B48_Prisoner_FB_ReviewerWksht.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Review Worksheet CIRB Review for Inclusion of Incarcerated Participants (Attachment B48)
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
96
Attachment B48 Prisoner FB Reviewer Worksheet
Attachment_B48_Prisoner_FB_ReviewerWksht.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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 NIH/HHS/OD
FR Citation:
67 FR 60742
Number of Respondents:
20
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
20
0
0
0
0
20
Annual IC Time Burden (Hours)
20
0
0
0
0
20
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.