Form 14 CTSU Generic Data Transmittal Form

Attachment_1n_dcf
attach_1gg_8788dtf

OMB#0925-xxxx
OMB#0925-0624
Expiration Date:
Expiration
Date:xx/xx/xxxx
12/31/2013

Public reporting burden for this collection of information is estimated to average 10 minutes per response,
Public reporting
burden
for this
collection searching
of information
is estimated
to vary
from and
5 tomaintaining
10 minutes the
per data
response,
including
the time for
reviewing
instructions,
existing
data sources,
gathering
including
time forand
reviewing
instructions,
searching
existing data
sources,
gathering
and or
maintaining
the data
needed,
and the
completing
reviewing
the collection
of information.
An agency
may
not conduct
sponsor, and
needed,
completing
and reviewing
the collection
of information.
agency amay
not conduct
or sponsor, and
a person
is and
not required
to respond
to, a collection
of information
unlessAn
it displays
currently
valid OMB
a person
is not
required
to respond
collection
of information
it displays
a currently
valid OMB
control
number.
Send
comments
regardingto,
thisaburden
estimate
or any otherunless
aspect of
this collection
of information,
controlsuggestions
number. Send
comments
thisNIH,
burden
estimate
or anyBranch,
other aspect
this collection
information,
including
for reducing
thisregarding
burden, to:
Project
Clearance
6705 of
Rockledge
Drive,ofMSC
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includingMD
suggestions
for reducing
this burden,
to: NIH,
Clearance
Branch,form
6705to
Rockledge
Drive, MSC 7974,
Bethesda,
20892-7974,
ATTN: PRA
(0925-0624).
DoProject
not return
the completed
this address.
Bethesda, MD 20892-7974, ATTN: PRA (0925-0624).
(0925-xxxx). Do not return the completed form to this address.

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4. Once completed, print the form.

Attachment_1n_dcf
attach_1gg_8788dtf

OMB#0925-xxxx
OMB#0925-0624
Expiration Date:
xx/xx/xxxx
Expiration
Date:
12/31/2013