NIH POLICY MANUAL

1730 - Forms Management
Issuing Office: OM/OMA/DMS (301) 496-2832
Release Date: 7/12/06


1. Explanation of Material TransmittedThis chapter updates the procedures required for recommending, creating, managing, monitoring, and eliminating forms used within NIH.  The chapter contains web site references for many types of electronic forms.  Organizational names are updated.

2. Filing Instructions:

Remove:  NIH Manual 1730 dated 3/1/86

Insert:  NIH Manual 1730 dated 7/12/06

Please noteFor information on:

§     Content of this chapter, contact the issuing office listed above.

§     NIH Manual System, contact the Division of Management Support, Office of Management Assessment, OM on (301) 496-2832.

§     On-line information, enter this URL: http://www1.od.nih.gov/oma/manualchapters

 


A. PurposeThis chapter describes the procedures required for managing paper and electronic forms used at NIH.

B. Background and References:

1. HHS Forms Manual.

2. Frequently Asked Questions About Forms, 3/31/03, prepared by the HHS Forms Management Officer.

3. The Privacy Act of 1974 (5 U.S.C. 552a), as amended.

C. Responsibilities:

1. The Division of Management Support (DMS), Office of Management Assessment, Office of Management, is responsible for the overall operation of the NIH forms management program.  Specifically, the NIH Forms Officer in DMS:

  • Develops and coordinates policy for NIH forms;
  • Provides centralized control of the creation, revision, and numbering of NIH forms;
  • Provides, manages, and updates the NIH Electronic Forms Home Page, a centralized web site, http://forms.nih.gov/, for NIH forms and other forms used by the NIH community;
  • Coordinates the printing of NIH forms when printed forms are appropriate (e.g., animal cage cards, certain tags);
  • Clears all directives that cite NIH forms to ensure the most current version is referenced;
  • Establishes and maintains historical files for NIH forms; and
  • Submits reports to the HHS Forms Management Officer, as required.

2. The NIH Project Clearance Branch in the Office of Extramural Research acts as liaison with other HHS components and the Office of the Secretary on public use forms, and assists NIH offices with clearing public use forms with OMB.

3. The Office of Logistics and Acquisition Operations (OLAO), OA, is responsible for stocking paper forms for the NIH community when requested and OLAO determines it is cost-effective to do so.

4. The originating office for each form is responsible for:

  • Obtaining necessary clearances,
  • Notifying the NIH Forms Officer when forms become obsolete, are superseded or are in need of revision, and
  • Maintaining paper supplies of forms that are not stocked by OLAO, when paper forms are needed.

5. The Privacy Act System Manager reviews all proposals for new, revised, or reprinted forms used to collect data that falls within a Privacy Act system of records to ensure conformity with the system notice and compliance with the requirements described in this chapter.  The checklist in Appendix 1 will assist the Privacy Act System Manager with the review.

6. Each IC Privacy Act Coordinator is responsible for reviewing new and revised form proposals originating in the organization which will be subject to the Privacy Act’s provisions governing the following:

  • requests for disclosure of Social Security numbers and
  • records describing how an individual exercises rights guaranteed by the First Amendment.

Each IC Privacy Act Coordinator will determine if the content, use, and filing of a form conforms with requirements of the Privacy Act.

7.  The NIH Privacy Act Officer must authorize any needed alteration of a system of records following procedures in the Privacy Act of 1974 (5 U.S.C. 552a), as amended (http://www.usdoj.gov/foia/privstat.htm).

D. Definitions:

1. Public Use Form (Information Collection Form) - Asks the same questions of ten or more persons (generally defined as non-government employees).  Advanced approval from the Office of Management and Budget (OMB) is required.  See Section I. These forms must carry an OMB clearance number, expiration date, and burden statement printed on the form.  Surveys, interviews, focus group guidelines, telephone screeners, questionnaires, and web based questionnaires are included in this requirement.

2. NIH Form - Form that is numbered under the central NIH forms system.  This generally excludes low-usage forms and forms used in limited areas.  The NIH Forms Officer can help determine when a form number should be assigned.

3. Revised Form - An edition of a form with changes in format, text, or specifications, relative to the original or previous edition.  Each NIH form shows a date of issue next to the form number, usually in the bottom left corner, so that it is easy to distinguish between various editions of the same form.

4. Privacy Act Record - Any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, his or her education, financial transactions, medical history, and criminal or employment history and that contains his or her name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a finger or voice print or a photograph (5 U.S.C. 552a(a)(4)).

5.  Privacy Act System of Records - A group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual (5 U.S.C. 552a(a)(5)).

6.  Numbered Series of Forms - The following types of forms are used at NIH.  Note that not all forms are available electronically; when available, the web site is provided.

a. HHS Forms - developed within the Department of Health and Human Services and prescribed for general use throughout HHS.  HHS forms are available from:  http://intranet.hhs.gov/forms/hhs_forms.html and http://www.hhs.gov/forms for HHS public-use forms.

b. NIH Forms - designed for NIH operations. An NIH form is produced when no other suitable form is available from higher sources. Sections F, G, and H of this chapter describe procedures and requirements for creating and revising NIH forms, and distributing, storing, and reordering forms.  NIH forms are available from:  http://forms.nih.gov/.

c. Optional Forms - coordinated and numbered by the General Services Administration, and are available for use on an optional basis to Government agencies.  The prefix “OF” in the form number identifies Optional Forms.  Optional Forms are available from:  http://www.gsa.gov/forms/.

d. Other Government Agency Forms - developed and numbered by other Federal agencies, but available for use throughout Government.  Some frequently used forms are available from:  http://forms.nih.gov/.

e. PHS Forms - used by one or more components of HHS.  PHS forms are available from:  http://intranet.hhs.gov/forms/phs_forms.html and http://www.hhs.gov/forms for PHS public-use forms.

f. Standard Forms - prescribed for mandatory use by Federal agencies. Standard Forms are approved and numbered by the General Services Administration.  The prefix “SF” in the form number identifies Standard Forms.  Please see the web site:  http://www.gsa.gov/forms/.

E. Policy:

1. Forms should be used when they will increase efficiency in collecting, storing, disseminating, or using information; increase productivity; or improve the quality or effectiveness of operations.

2.  All forms shall be issued and used in compliance with all applicable laws, regulations, and directives.

3. Forms should be designed so as to reduce costs incident to filling in, using and filing forms; and to achieve savings in designing, printing, storing and distributing forms.

F. Format Standards:

1. Title - Each NIH form shall show a title which concisely describes the function or purpose of the form.

2. Numbering - The number is usually located in the lower left corner of all pages of the form.  All NIH forms have “NIH” as a prefix.  A series of related forms may be assigned a number with suffixes.  For example, the following three forms are all used to apply for parking permits and have the same root number, NIH 2788.  They are distinct forms for different groups of users.  The suffixes, -1, -2, and -3, make them unique forms:

  • NIH 2788-1 - Renewal For Parking Permits for General Permits, Off-Campus Permits, Red Permits, and Satellite Permits.
  • NIH 2788-2 - Request for Campus Parking Permit for Contract Employees.
  • NIH 2788-3 - Mail-in Renewal for Carpool Permits.

3.  Date - NIH forms are identified by the month and year in which they were originated or revised. This date is shown on the form next to the form number and is put in parentheses.  When a form is revised, the new date is preceded by “Rev.”

4.  Privacy Act Systems of Record (SOR) Numbers - NIH forms that are used in systems of records, as defined by the Privacy Act, must display the system number(s) assigned to the system(s) of records. The NIH Privacy Act Officer assigns systems numbers to NIH systems of records.

5.  OMB Clearance Numbers - Public use forms (information collection forms) must carry an OMB clearance number, expiration date, and burden statement printed on the form, in the manner that OMB mandates.

G. Procedures for Creating and Revising NIH Forms: 

1. When a program official determines that a new form is needed for NIH operations, the requesting office submits the following documents to the NIH Forms Officer:

  • One copy of a draft of the proposed form, either on paper or electronically.
  • Reference to any directive relating to the form, such as an NIH Manual Chapter.
  • CSA printing requisition from the Delpro system, if the form is to be printed.
  • For public use forms, the OMB clearance documentation.

2. If forms design is needed, the requesting office may contact either the Division of Medical Arts and Printing Services, ORS, at (301) 435-9313 or the Medical Arts Branch of the Program Support Center , HHS, at (301) 442-1090.  Both organizations can produce electronic and paper forms.

3. The NIH Forms Officer approves the finalized form and posts it on the NIH forms web site or forwards it to Division of Medical Arts and Printing Services for printing, as applicable.

H. Availability of NIH Forms:

1. The majority of NIH forms are available on the NIH forms web site at http://forms.nih.gov.  The NIH Supply Catalogue, at http://www.olao.od.nih.gov/Acquisitions/TypeOfAcquisitions/SuppliesAndEquipment/FindingASource/SupplyCatalog.htm, provides some non-electronic forms in the Envelopes and Forms section.  For all other NIH forms, contact the NIH Forms Officer, at (301) 496-2832, for source information.

  • To use the forms on the NIH forms web site, go to http://forms.nih.gov and select the software that will be used.  The choices are FileMaker Pro, JetForm Form Flow, Microsoft Word, and Adobe Acrobat Reader.  The next page offers listings of forms by general subject area.  A complete listing is also offered.  From the selected list, either scroll down or use the search capability of the web browser to find the desired form.
  • The electronic forms on the NIH forms web site were designed to be filled in electronically.  They can also be printed out and then filled in.  Electronic routing of completed forms is not currently available.
  • Electronic forms show the release date in red in the upper left corner of the form.  This is the date that the form was posted to the web site, and does not appear when the form is printed.

2. Where demand is sufficient to support central storage costs, paper NIH forms are stocked by NIH Supply Services in OLAO. Offices wishing to have an NIH form stored centrally should submit a written request to the Division of Logistics Services (mailing address:  Gaithersburg Distribution Center , 16050 Industrial Drive , Room 310, Gaithersburg MD 20877 ).  Storage of paper forms not stocked by OLAO is the responsibility of the form’s originator.

3. Each form’s originating office is responsible for maintaining paper supplies of forms that are not stocked by OLAO, when paper forms are needed.  To reprint forms, send the following to the NIH Forms Officer: the printing requisition from the Delpro system and one copy of the requested form (mailing address:  6011 Executive Blvd., Suite 601 , Rockville , MD 20852 ).

I. Special Requirements:

1. Public Use Forms - In addition to the requirements described in Sections G and H, a copy of the approval notice from OMB must be submitted to the NIH Forms Officer with any request to create or revise a public use form (see Section D-1).  For information on obtaining OMB approval, contact the NIH Project Clearance Office, OER, and consult their web site, http://odoerdb2.od.nih.gov/oer/policies/project_clearance/pcb.htm (NIH access only) or call them on (301) 435-0978.

2. Forms Subject to the Privacy Act of 1974 - The originating office, consulting with the IC’s Privacy Act Coordinator, must identify any form that is subject to the Privacy Act.  A form is subject to the Privacy Act if it collects personally identifiable information, such as Social Security number, patient identification number, home address, home phone number, personal financial or medical information.

a. When a form requests records subject to the Privacy Act, the form must either include a Privacy Act Notification Statement or have a statement attached to it which informs the individual of:

(1) Government authorization (statute or Executive Order).

(2)  Purpose of information collection.

(3) Routine uses for information disclosure.

(4) Whether the request is voluntary or mandatory.

(5) What effect, if any, there is for not providing information.

For further information, please contact your IC Privacy Act Coordinator.

b.  Forms used to record information on individual exercise of First Amendment rights must satisfy the stringent requirements of the Privacy Act, subsection (e)(7). The Privacy Act prohibits the government from maintaining any record on how an individual exercises First Amendment rights unless one of the following conditions is met:

(1)  A statute explicitly authorizes the agency to maintain such a record. It is not sufficient if the information is relevant to an authorized activity. For example, while information on religious beliefs may be relevant in some research studies, general authority to conduct research is not sufficient to authorize collection of information about religion;

(2) The record is required by the agency for an authorized law enforcement function. In this context, law enforcement is not limited to enforcement of criminal laws; it may also extend to an agency’s human resources management. For example, in carrying out its management responsibilities, an agency may keep records on statements made by employees when speaking or writing as representatives of the agency;

(3) The individual expressly authorizes or knowingly volunteers the information. It should be made clear to the individual that providing information on how he/she exercises his/her First Amendment rights is entirely voluntary (unless covered by #1 or #2 above) and that there will be absolutely no negative consequences if the individual does not provide it.

c.  If a form is filed in a collection of records from which information is or will be retrieved by reference to an individual’s identity, then the form is part of the Privacy Act system of records. For such forms, follow the checklist included as Appendix 1 to this chapter.

J. Records Retention and Disposal:

All records (e-mail and non-e-mail) pertaining to this chapter must be retained and disposed of under the authority of NIH Manual 1743, “Keeping and Destroying Records”; Appendix 1; Part 1; Section 1700 Management Services; B-4, Records Management, Forms Management Files.

 

NIH e-mail messages (messages, including attachments that are created on NIH computer systems or transmitted over NIH networks) that are evidence of the activities of the agency or have informational value are considered Federal records. These records must be maintained in accordance with current NIH Records Management guidelines. If necessary, back-up file capability should be created for this purpose. Contact the IC Records Officer for additional information.

 

All e-mail messages are considered Government property, and, if requested for a legitimate government purpose, must be provided to the requester. Employees’ supervisors, NIH staff conducting official reviews or investigations, and the Office of the Inspector General may request access to or copies of the e-mail messages. E-mail messages must also be provided to Congressional oversight committees if requested and are subject to Freedom of Information Act requests. Since most e-mail systems have back-up files that are retained for significant periods of time, e-mail messages and attachments are likely to be retrievable from a back-up file after they have been deleted from an individual’s computer. The back-up files are subject to the same requests as the original messages.  

K. Management ControlsThe purpose of this manual issuance is to establish the NIH policy for managing forms used within NIH.

1.    Review of Management Controls.  Through this manual issuance, the NIH Forms Officer is responsible for the method used to ensure that the management controls are implemented and working.

2.  Frequency of Review:  Ongoing.

3.  Method of Review:  The NIH Forms Officer reviews NIH forms to ensure compliance with this policy.

4.  Review Reports:  Are sent to the DDM upon request indicating that controls are in place and working well or include any management control issues that should be brought to the attention of the DDM.

Appendix 1. Checklist for Forms which come under Privacy Act Systems of Records:

1. Include on the form the unique number(s) of the Privacy Act system(s) of records in which the form will be used (for example:  09-25-0005).  For a listing of NIH Privacy Act Systems of Records, go to the OMA web site at http://oma.od.nih.gov/ms/privacy/pa-files/read02systems.htm.

2. Compare the information which will be recorded on the form with the descriptions in the notice of system of records. Specifically, check that:

a. The form will be filed only at places listed in the “System Location” section of the notice.

b. The individuals on whom information will be recorded on the form fall within the “Categories of Individuals” described in the notice.

c. The information on the form falls within the “Categories of Records” described in the notice.

d. The intended use of the form within the agency is consistent with the “Purpose” section of the notice.

e. Any intended use or disclosure of the form outside of HHS is authorized by a “Routine Use” specified in the system notice, or by one of the provisions in section (b) of the Privacy Act of 1974, 5 U.S.C. §552a (as amended).

f. The physical medium in which the form will be maintained (e.g. paper, electronic) is listed in the “Storage” section.

g. The type(s) of individual identifiers (e.g., name, SSN) which will be used to retrieve the form are specifically included in the “Retrievability” section of the notice.

h. The form will be protected according to the “Safeguards” section described in the notice.

i. The form will be retained and disposed of in accordance with the authorized “Retention and Disposal” section described in the notice.

j. The notification and access official(s) identified in the notice will be able to locate forms pertaining to specific individuals, given the information specified in the “Notification Procedure” and “Record Access Procedure” sections.

If any of these conditions are not met, either the form must be changed or the system of records must be altered. The NIH Privacy Act Officer must authorize any alteration of the system of records.

3. Provide a Privacy Act Notification Statement on the form itself, or as an attachment, for individuals who will be asked to provide information about themselves. The notification must state:

a. Government authorization (statute or Executive Order).

b.  Purpose of information collection.

c. Routine uses for information disclosure.

d. Whether the request is voluntary or mandatory.

e. What effect, if any, there is for not providing information.

Questions should be directed to the IC Privacy Act Coordinator. For a list of IC points of contact, go to the OMA web site at http://oma.od.nih.gov/about/contact/browse.asp?fa_id=3.  

If the form is being proposed for use on an IC web site, please refer to Manual Chapter 2805, “NIH Web Page Privacy Policy” at http://www1.od.nih.gov/oma/manualchapters/management/2805.

 

 

 

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