OMB
.report
Search
IRB Authorization Agreement (REVIEW)
[OS] Centralized Institutional Review for the CDC Expanded Access Investigational New Device (EA-IND) for "Use of Tecovirimat (TPOXX®) for Treatment of Human Non-Variola Orthopoxvirus Infections.
OMB: 0920-1404
IC ID: 258780
OMB.report
HHS/CDC
OMB 0920-1404
ICR 202302-0920-004
IC 258780
( )
Documents and Forms
Document Name
Document Type
Form 0920
IRB Authorization Agreement (REVIEW)
Form and Instruction
0920 CDC IRB Authorization Agreement (COMPLETE)
CDC_IRB_Authorization_Agreement_FINAL (4).pdf
Form and Instruction
0920 CDC IRB Authorization Agreement (COMPLETE)
CDC_IRB_Authorization_Agreement_FINAL (4).pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
IRB Authorization Agreement (REVIEW)
Agency IC Tracking Number:
0920-22HY
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
0920
CDC IRB Authorization Agreement (COMPLETE)
CDC_IRB_Authorization_Agreement_FINAL (4).pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
500
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
500
0
500
0
0
0
Annual IC Time Burden (Hours)
500
0
500
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.