NBB Tissue Access Request Form (NIH-Funded Research)

The National Institutes of Health (NIH) NeuroBioBank Tissue Access Request and Progress Report Forms

Documents and Forms

Document Name Document Type
Form 1 NBB Tissue Access Request Form (NIH-Funded Research) Form
1 Access Request Att 1_NBB Tissue Access Request_NIH.pdf Form

Information Collection (IC) Details

IC Title:	NBB Tissue Access Request Form (NIH-Funded Research)	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	1	Access Request	Att 1_NBB Tissue Access Request_NIH.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Extramural Awards and Chartered Advisory Committees (IMPAC 2), Contract Information (DCIS), and Cooperative Agreement Information, HHS/NIH	FR Citation: 67 FR 60742

Number of Respondents: 200	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200	-200	400
Annual IC Time Burden (Hours)	50	-50	100
Annual IC Cost Burden (Dollars)	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.