NDA Data Use Certification (DUC)

NDAR Data Access Request (NIMH)

Documents and Forms

Document Name Document Type
Form 2 NDA Data Use Certification (DUC) Form and Instruction
2 Certification Data Use Certification_05.08.23.docx Form and Instruction
2 Certification Data Use Certification_05.08.23.docx Form and Instruction

Information Collection (IC) Details

IC Title:	NDA Data Use Certification (DUC)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	2	Certification	Data Use Certification_05.08.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD	FR Citation: 67 FR 60742

Number of Respondents: 950	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	950	950
Annual IC Time Burden (Hours)	1,425	1,425
Annual IC Cost Burden (Dollars)	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.