Form 1 IRB Transmittal

OMB# 0925-0753
Expiration Date 7/31/2021

CTSU Transmittal Sheet
Public reporting burden for this collection of information is estimated to average 2 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974,
Bethesda, MD 20892-7974, ATTN: PRA (0925-0753). Do not return the completed form to this address.

The following Transmittal Sheet is auto-populated with information regarding your regulatory submission.

Submission Type:

Site Registration

Packet Type:

X Normal

Urgent (patient(s) to be enrolled in the next three days)

Applicable NCI Institution Codes:
MN008(A011104,A011202), MN010(A011104,A011202), MN040(A011104,A011202)

Person CTEP IDs:
N/A

Protocol Contact at Site:

Comments:

Nadia

Goranova

First Name

Last Name

(240) 314-2421

nadiagoranova@westat.com

Phone

e-mail

This is test regulatory submission comment.

Created Date:

11/23/2020 10:42:15 AM