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International Investigator Statement (IIS)
Investigational Agent Accountability Record Forms in the Conduct of Investigational Trials in Cancer Treatment (NCI)
OMB: 0925-0613
IC ID: 250488
OMB.report
HHS/NIH
OMB 0925-0613
ICR 202409-0925-001
IC 250488
( )
Documents and Forms
Document Name
Document Type
Form 4
International Investigator Statement (IIS)
Form and Instruction
4 International investigator statement
Attachment 4 - International Investigator Statement.pdf
Form and Instruction
4 International investigator statement
Attachment 4 - International Investigator Statement.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
International Investigator Statement (IIS)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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
4
International investigator statement
Attachment 4 - International Investigator Statement.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 National Institutes of Health (NIH) HHS/NIH/OD
FR Citation:
67 FR 60776
Number of Respondents:
2,100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
0
0
0
-2,100
0
2,100
Annual IC Time Burden (Hours)
0
0
0
-525
0
525
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.