DERT Extramural Grantee Data Collection (NIEHS)

Forms and Documents

Document Name	Status
Form 1 NIEHS simplified data collection form Form	Unchanged
Form 1 DERT Extramural Grantee Data Collection Survey Form	Unchanged
Attachment B_ NIDCD Connections between Simplified Form and Approved Form.pdf Supplementary Document	2019-02-13
Attachment A_ NIDCD Simplified Data Collection Form 2019.docx Supplementary Document	2019-02-13
NIDCD DERT Change Request Memo Jan 2019.docx Justification for No Material/Nonsubstantive Change	2019-02-13
Attachment A 2018-2021 NIEHS DERT Grantee Survey.docx Supplementary Document	2018-12-20
NIEHS DERT Change Request Memo Dec 2018.docx Justification for No Material/Nonsubstantive Change	2018-12-20
30-day common form2018-22038.pdf Supplementary Document	2018-10-11
FINAL NIEHS DEGDC commonform support_stmt_a 2018 (6).docx Supporting Statement A	2018-10-09
Attachment C NIEHS DEGDC Table Shells.docx Supplementary Document	2018-10-03
Attachment B PIA for NIEHS DERT Extramural Granttee Data Collection DEGDC (Feb 2012).pdf Supplementary Document	2018-10-03

IC Document Collections

IC ID	Document Title	Status
234598	NIEHS simplified data collection form Form	Unchanged
233400	DERT Extramural Grantee Data Collection Survey Form	Unchanged

ICR Details

OMB Control No: 0925-0757	ICR Reference No: 201902-0925-003
Status: Historical Inactive	Previous ICR Reference No: 201812-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: DERT Extramural Grantee Data Collection (NIEHS)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 02/19/2019
	Date Received in OIRA: 02/14/2019
Terms of Clearance: Requesting components will submit requests to use the approved common forms in their totality without amendments. These submissions will include a memo describing the specific study goals, sampling and analysis plans, and how the instrument will be used.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	11/30/2021	11/30/2021
Responses	1,640	0	1,640
Time Burden (Hours)	740	0	740
Cost Burden (Dollars)	0	0	0

---

Abstract: The National Institute of Environmental Health Sciences (NIEHS) is requesting the Extramural Grantee Data Collection Survey be converted to a “Common Form” to include EPA.

---

Authorizing Statute(s): US Code: 42 USC 285 Name of Law: Public Health Service Act
  

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:
	83 FR 19073	05/01/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 51470	10/11/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
NIEHS simplified data collection form	1	NIEHS Simplified Form
DERT Extramural Grantee Data Collection Survey	1	NIEHS DERT Grantee Survey

---

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: No

Burden Reduction Due to:

Short Statement: The burden increase is only due to the additional respondent group.

---

Annual Cost to Federal Government: $20,638

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? Uncollected

---

Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

---

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: 02/14/2019

---