View Information Collection Request (ICR) Package
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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:
0925-0770
ICR Reference No:
202409-0925-006
Status:
Active
Previous ICR Reference No:
202103-0925-002
Agency/Subagency:
HHS/NIH
Agency Tracking No:
Title:
The Inclusion Enrollment Report Form
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
Yes
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
11/27/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/27/2024
Terms of Clearance:
Concluded consistent with the understanding that in the next revision/extension of the package (no later than March 28, 2029), the agency will update the race/ethnicity question in this information collection to be in compliance with the updated SPD 15 (effective as of March 28, 2024).
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2027
36 Months From Approved
11/30/2024
Responses
69,888
0
67,888
Time Burden (Hours)
69,888
0
67,888
Cost Burden (Dollars)
0
0
0
Abstract:
NIH is requesting an extension of a currently approved collection. NIH converted the Inclusion Enrollment Report form (IER) to a common from during the last approval cycle which included the Department of Defense (DoD). Previously, the form was housed in NIH’s Pre/Post grant application and forms clearances approved under OMB#s 0925-0002 and 0925-0002 (expiration date 1/31/2026).
Authorizing Statute(s):
US Code:
42 USC CFR Part 52
Name of Law: Grants and Research Projects
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
89 FR 59746
07/23/2024
30-day Notice:
Federal Register Citation:
Citation Date:
89 FR 79300
09/27/2024
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Inclusion Enrollment Form
1
Form
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
69,888
67,888
0
2,000
0
0
Annual Time Burden (Hours)
69,888
67,888
0
2,000
0
0
Annual Cost Burden (Dollars)
0
0
0
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:
The previous burden estimate was inadvertently keys in incorrectly which shows a difference of 2,000. There are no changes of burden from the last approval cycle.
Annual Cost to Federal Government:
$39,594
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:
Mikia Currie 3014350941
Common Form ICR:
Yes
Description/Changes for Common Form Usage:
NIH converted the Inclusion Enrollment Report form (IER) to a common from during the last approval cycle which included the Department of Defense (DoD). Previously, the form was housed in NIH’s Pre/Post grant application and forms clearances approved under OMB#s 0925-0002 and 0925-0002 (expiration date 1/31/2026).
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
DOD/DOA
202411-0702-001CF
DoD Usage of Inclusion Enrollment Report Form
Active
Inclusion Enrollment Form
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/27/2024
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