Private sector

Electronic Application for NIH Certificates of Confidentiality (CoC E-application System)

Documents and Forms

Document Name Document Type
Form 1 Private sector Form and Instruction
1 Certification of Confidentiality Attachment 1 - Certificate of Confidentiality Request.pdf Form and Instruction
2 Assurance Statement Attachment 1 Update assurance statement NOV 2024. clean.docx Form

Information Collection (IC) Details

IC Title:	Private sector	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Certification of Confidentiality	Attachment 1 - Certificate of Confidentiality Request.pdf		Yes	Yes	Fillable Fileable
Form	2	Assurance Statement	Attachment 1 Update assurance statement NOV 2024. clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0225, NIH Electronic Research Administration (eRA) Records, HHS/NIH/OD/OER	FR Citation: 67 FR 67042

Number of Respondents: 795	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 %

	Requested	Previously Approved
Annual Number of Responses for this IC	795	795
Annual IC Time Burden (Hours)	1,193	1,193
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.