View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View Generic ICR - OIRA Conclusion

OMB Control No: 0925-0641	ICR Reference No: 201712-0925-001
Status: Historical Active	Previous ICR Reference No: 201409-0925-008
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Generic Submission for Formative Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/29/2018
	Date Received in OIRA: 12/08/2017
Terms of Clearance: This generic ICR is approved consistent with NIH agreement to submit individual colletions to OMB as they are implemented, along with all necessary supporting statements (to include information about research design and analysis, incentives, burden estimates, approaches to address non-response bias, etc). OMB will aim to review each IC submission within 14 days; however, OMB approval should not be assumed if not explicitly granted, even if 14 days have elapsed since submission. Approval for this generic ICR should not be construed as approval for this particular IC. All collections subject to the Privacy Act will include a Privacy Act statement somewhere on the instrument

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved	01/31/2018
Responses	270	0	2,925
Time Burden (Hours)	135	0	3,075
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	270	2,925	-2,655
Annual Time Burden (Hours)	135	3,075	-2,940
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is an extension. Since the database is fully developed, with only occasional and minor edits to be made, the program is asking for a reduction in burden hours. Annual burden hours for previous submission (2014) were proposed at 1025, annual burden hours for current submission (2017) are proposed at 45, for a 980 annual burden-hour reduction. Previous submission (2014) respondents were 975 and proposed respondents (2017) are now 90, this is a reduction of 885.

Annual Cost to Federal Government: $25,613

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Tawanda Abdelmouti 240 276-5530 ta401@nih.gov

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