Common use of Accurate Representations Clause in Contracts

Accurate Representations. Submitter expressly certifies that the contents of any statements made or reflected in this document are truthful and accurate. Public reporting burden for this collection of information is estimated to vary from 15 min to 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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, 0000 Xxxxxxxxx Xxxxx, XXX 0000, Xxxxxxxx, XX 00000- 0000, ATTN: PRA (0925-0667). Do not return the completed form to this address. 1. Submitter Information: 2. Data Repository: See xxxxx://xxx.xxx.xxx/about/about-us.html for a current list of NDA data repositories. 3. Research Project: Research Project Title: Funding Source: Grant/Contract Number: Clinical Trial ID (NCT#): Existing Samples/Data – Source(s): Existing Samples/Data – Source(s): Subject Enrollment – Targeted/Planned Enrollment: Funding Amount: Project Dates: From To Program Official: Program Official Email: Grant Management (GM) Contact: GM Email: Project Description (Use additional sheets as needed):

Accurate Representations. Submitter expressly certifies that the contents of any statements made or reflected in this document are truthful and accurate. Public reporting burden for this collection of information is estimated to vary from 15 min to 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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, 0000 Xxxxxxxxx Xxxxx, XXX 0000, Xxxxxxxx, XX 00000- 0000, ATTN: PRA (0925-0667). Do not return the completed form to this address. 1. Submitter Information: 2. Data Repository: Repository See xxxxx://xxx.xxx.xxx/about/about-us.html for a current list of NDA data repositories. 3. Research Project: Project Research Project Title: Title Funding Source: Grant/Contract Number: Clinical Trial ID (NCT#): Existing Samples/Data – Source(s): Existing Samples/Data – Source(s): ) Subject Enrollment – Targeted/Planned Enrollment: _ Funding Amount: Project Dates: From _ To Program Official: Program Official Email: Grant Management (GM) Contact: GM Grant Management Email: Project Description (Use additional sheets as needed):