View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0915-0295	ICR Reference No: 200411-0915-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Grant Reviewer Recruitment Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/03/2005
	Date Received in OIRA: 11/23/2004
Terms of Clearance: Approved consistent with the following terms: as soon as possible but no later than 02/11/05 HRSA shall submit a revised copy of the form reflecting changes discussed in the Agency memo submitted to OMB 02/01/05. Specifically, HRSA shall amend the race ethnicity question to comply with OMB government wide standards and will request only the last four didgits of respondents social security numbers.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2008	02/29/2008
Responses	4,900	0	0
Time Burden (Hours)	2,750	0	0
Cost Burden (Dollars)	0	0	0

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