Notice: Submission of information is voluntary. All submitted information will be made publicly available.
OMB NO: 0925-0612 EXPIRATION DATE: 7/31/2016 Public reporting burden for this collection of information is estimated to average 3 minutes per response.
This estimate includes the time for reviewing instructions, gathering, and entering data. An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0612).
Do not return the completed form to this address.