Information Collection

NIH Other Transaction Application Form

IC 256274 under ICR 202408-0925-001 · OMB 0925-0001.

Documents and Forms

Document Name Document Type
Form 1 NIH Other Transaction Application Form Form
1 Form Attachment 20A_Other Transaction application form_ASSIST screenshots.pdf Form
1 Form Attachment 20A_Other Transaction application form_ASSIST screenshots.pdf Form
2 Form Attachment 20B_ASSIST-Instruction-Guide-for-NIH-Other-Transactions.docx Form
2 Form Attachment 20B_ASSIST-Instruction-Guide-for-NIH-Other-Transactions.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NIH Other Transaction Application Form	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	Form	Attachment 20A_Other Transaction application form_ASSIST screenshots.pdf		Yes	Yes	Fillable Fileable
Form	2	Form	Attachment 20B_ASSIST-Instruction-Guide-for-NIH-Other-Transactions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 239	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	239	239
Annual IC Time Burden (Hours)	2,629	2,629
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.