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Trainees
Center for Cancer Training (CCT) Application Form for lectronic Individual Development Plan (eIDP) (NCI)
OMB: 0925-0762
IC ID: 236239
OMB.report
HHS/NIH
OMB 0925-0762
ICR 201905-0925-005
IC 236239
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0762 can be found here:
2022-04-28 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Trainees
Form and Instruction
1 Trainee screenshots
Att 1a-eIDP Trainee Screenshots.pdf
Form and Instruction
Att 1b-eIDP Burden Statement.pdf
burden statement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Trainees
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
Trainee screenshots
Att 1a-eIDP Trainee Screenshots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
#09–25–0014, “Clinical Research; Student Records, HHS/PHS/NIH/OD/OIR/OE
FR Citation:
67 FR 60742
Number of Respondents:
1,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,000
0
1,000
0
0
0
Annual IC Time Burden (Hours)
1,000
0
1,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
burden statement
Att 1b-eIDP Burden Statement.pdf
05/29/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.