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 ICR - OIRA Conclusion

OMB Control No: 0925-0723	ICR Reference No: 202109-0925-003
Status: Historical Active	Previous ICR Reference No: 201806-0925-001
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Neurobiobank Tissue Access Request (NBB) NIMH
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/26/2021
	Date Received in OIRA: 09/21/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2024	36 Months From Approved	11/30/2021
Responses	400	0	225
Time Burden (Hours)	100	0	56
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	400	225	175
Annual Time Burden (Hours)	100	56	44
Annual Cost Burden (Dollars)	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: There have been changes to the information collected by the NBB Tissue Access Request Form (Attachment 1). Based upon a review of the past response rate, NIMH has updated the number of estimated respondents to 400 from 225. Given the further streamlining of the form, NIMH estimates the form will take only 15 minutes to complete. The “Requestor Information” portion of the request form now asks for the name and email address for the Principal Investigator if that individual is not the requestor. The “Research Funding Information” portion of the request form has been streamlined for the requestors. Additionally, this portion of the request form now asks if the researched related to the request is supported by funding from the NIH. If the funding is NIH-related, the requestor must provide information on whether the funding is extramural or intramural, which IC it is affiliated with, and the six-digit project serial number.

Annual Cost to Federal Government: $58,723

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? No

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

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.