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OMB Control No: 0925-0705	ICR Reference No: 202606-0925-002
Status: Received in OIRA	Previous ICR Reference No: 202507-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Chimpanzee Research Use Form (OD)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 06/25/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2026
Responses	30	20
Time Burden (Hours)	15	10
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	30	20	10
Annual Time Burden (Hours)	15	10	5
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: This extension constitutes an adjustment which increased the number of respondents from 20 respondents to 30 respondents.

Annual Cost to Federal Government: $11,392

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. No

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. No

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

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