APPLICATION FOR STAFF FELLOWSHIP PROGRAM

ICR 197712-0925-002

OMB: 0925-0005

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
111176 Migrated
ICR Details
0925-0005 197712-0925-002
Historical Active 197503-0925-004
HHS/NIH
APPLICATION FOR STAFF FELLOWSHIP PROGRAM
Revision of a currently approved collection   No
Regular
Approved without change 12/06/1977
Retrieve Notice of Action (NOA) 12/01/1977
  Inventory as of this Action Requested Previously Approved
01/31/1982 01/31/1982 06/30/1980
1,500 0 295
1,500 0 295
0 0 0

THE APPLICATION PROVIDES INFORMATION ON BASIC EXPERIENCE, SKILL AND EDUCATION THAT IS NEEDED TO EVALUATE APPLICANTS' QUALIFICATIONS FOR APPOINTMENTS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR STAFF FELLOWSHIP PROGRAM PHS-3997

  Total Approved 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 1,500 295 0 0 1,205 0
Annual Time Burden (Hours) 1,500 295 0 0 1,205 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/01/1977


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