Special Volunteer and Guest Researcher Assignment (OD)

Forms and Documents

Document Name	Status
Form 1 NIH Guest Research Agreement Form	Modified
Form 1 NIH Special Volunteer Agreement Form	Modified
Form 1 Special Volunteer and Guest Research Assignment Form	Modified
30day 0177.pdf Supplementary Document	2025-12-18
SSA for Extension of SV-GR Assignment.docx Supporting Statement A	2025-12-17

IC Document Collections

IC ID	Document Title	Status
229194	NIH Guest Research Agreement Form	Modified
229153	NIH Special Volunteer Agreement Form	Modified
229152	Special Volunteer and Guest Research Assignment Form	Modified

ICR Details

OMB Control No: 0925-0177	ICR Reference No: 202512-0925-003
Status: Received in OIRA	Previous ICR Reference No: 202212-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Special Volunteer and Guest Researcher Assignment (OD)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/19/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2026
Responses	6,900	6,900
Time Burden (Hours)	652	652
Cost Burden (Dollars)	0	0

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Abstract: This is an extension request (no revisions) of an approved collection, OMB Control #0925-0177, with an expiration date of 03/31/2026. Because data required for these two Programs are similar, a consolidated Form NIH-590 is used (See Attachment 1, no revision requested). This form number and the data collected has not changed from the last approval cycle.

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Authorizing Statute(s): US Code: 42 USC 282(b)(10) Name of Law: Public Heath Service Act
   US Code: 42 USC 284 (b) (1) (K) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 46230	09/25/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 59135	12/18/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
NIH Guest Research Agreement	1	Agreement
NIH Special Volunteer Agreement	1	Agreement
Special Volunteer and Guest Research Assignment	1	Assignment

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	6,900	6,900	0	0	0	0
Annual Time Burden (Hours)	652	652	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $47,939

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/19/2025

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