Instructions for PHS 2271 Form Approved Through 9/30/2010
Revised 9/2007 OMB No. 0925-0001
The Public Health Service (PHS) estimates that it will take 15 minutes to complete this form. This includes time for reviewing the instructions, gathering needed information, and completing and reviewing the form. 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. If you have comments regarding the amount of time it takes to complete this form or any other aspects of this collection of information, including suggestions for reducing this burden, send comments to: NIH, Project Clearance Office, 6705 Rockledge Drive MSC 7974, Bethesda, MD 20592-7974, ATTN: PRA (0925-0001). Do not return the completed form to this address.
This form is to be used to appoint individuals as trainees to institutional Ruth L. Kirschstein-National Service Research Award (Kirschstein-NRSA) programs (e.g., T32, T34, T35) and non-NRSA institutional research training programs (e.g., T15). It can also be used to document the appointment of scholars to institutional career development awards (e.g., K12) and individual participants to research education awards (e.g., R25).
Please read carefully the following instructions, including the Privacy Act Statement at the end of this document. All items on the form must be completed unless otherwise indicated in these instructions.
Types of Awards
Kirschstein-NRSA. Awards that provide undergraduate, predoctoral, and postdoctoral research training support under the authority of Section 487 of the PHS Act (42 USC 288). All Kirschstein-NRSA trainees must meet specific citizenship requirements – for details, see Item 8.
Non-NRSA Research Training. Awards that provide predoctoral and postdoctoral research training support through non-NRSA funding authorities. These training programs generally do not have the same provisions and requirements as Kirschstein-NRSA awards (e.g., specific citizenship requirements).
Career Development. Awards that provide doctoral-level investigators an opportunity to enhance their research careers. Individuals appointed to institutional career development awards must meet specific citizenship requirements—for details, see Item 8.
Research Education. Awards that provide support for programs intended to attract investigators to a specific field of study. Individuals appointed to research education award programs may or may not be subject to specific citizenship requirements—for details, see Item 8.
Types of Appointments
Trainee. A person appointed to and supported by an institutional Kirschstein-NRSA or non-NRSA research training award.
Scholar. A person appointed to and supported by an institutional career development award.
Participant. A person appointed to and supported by a research education award.
A “Statement of Appointment” form covers the support of an individual for a particular budget period and is required for each new appointment, reappointment, or amended appointment of an individual receiving stipend, tuition costs, or travel expenses as a trainee under a PHS institutional training grant, or salary as a scholar or participant under a career development or research education program award in which the institution selects and appoints the individual. The form (which is signed by both the individual and the Program Director) must be completed and submitted to PHS at the time the individual starts the appointment or reappointment, or, in the case of an amendment, as soon as the change occurs. If there are multiple Program Directors on the award, the contact PD should sign.
For new postdoctoral trainees appointed to Kirschstein-NRSA institutional grants, a signed and dated payback agreement must be submitted with this appointment form before a stipend or other allowance may be paid.
The original should be sent to the awarding component. A copy should also be given to the trainee, scholar, or participant, the Program Director, and Business Official.
Item 1. PHS Grant Number.
Insert the entire PHS Grant Number as shown on the
particular Notice of Grant Award from which funds are provided,
e.g., 5 T32 GM12453-03 would be listed as
Type: 5; Activity
Code: T32; ID Serial Number: GM12453-03.
Item 2. Trainee/Scholar/Participant Name. Include maiden name or other names in parentheses where applicable.
Item 3. Sex. Self-explanatory.
Item 4. Type of Action.
New Appointment: When an individual has not been previously supported by this training grant.
Reappointment: When an individual was supported by this grant during a previous budget period, the appointment covered by this form is designated a reappointment. Skip the shaded items if the information provided will be the same as that reported during the prior budget period. Always complete the non-shaded items.
Amendment: “Amendment” pertains only to a change of item 2 (Name); 9 (Permanent Mailing Address); 15 (Appointment Period); or 20 (Support from this Grant) during a period of appointment for which a “Statement of Appointment” form has already been submitted. Amendments must be submitted as soon as the change occurs. Complete only items 1, 2, 4, 6, 22, 23, and the item(s) to be amended.
Item 5. Prior NRSA Support. Individuals being appointed to a Kirschstein-NRSA institutional grant for the first time or being reappointed after a break in support must indicate if they have received prior Kirschstein-NRSA support from either an individual award or institutional grant. If yes, specify on the form the dates of support, the level (pre- or post-), the mechanism (individual award or institutional grant), and the grant number, if known. (See the Program Guidelines for limitations on total period of support.)
Item 6. Social Security Number. Trainees/scholars/participants are asked to voluntarily provide the last four digits of their Social Security Numbers. This information provides the agency with vital information necessary for accurate identification and review of appointments and for management of PHS grant programs. See the Privacy Act Statement at the end of these instructions for further information concerning this request.
Item 7. Birthdate. Self-explanatory.
Item 8. Citizenship. Check the box corresponding to the trainee’s, scholar’s, or participant’s citizenship and visa status. If not a U.S. citizen, list the country of citizenship.
A noncitizen national is an individual who, although not a citizen of the United States, owes permanent allegiance to the United States. Individuals in this category are generally born in lands which are not States, but which are under U.S. sovereignty, jurisdiction, or administration (e.g., American Samoa).
Kirschstein-NRSA trainees and institutional career development scholars must be U.S. citizens, non-citizen nationals, or permanent residents of the United States. Individuals on temporary or student visas are not eligible. Trainees or scholars in these programs who are permanent residents of the U.S. must submit a notary’s signed statement with this appointment form certifying that they have (1) a Permanent Resident Card (USCIS Form I-551), or (2) other legal verification of such status.
Trainees in non-NRSA research training programs and participants in research education award programs should consult the applicable Funding Opportunity Announcement (FOA) for citizenship requirements.
Item 9. Permanent Mailing Address. Give an address where the appointed individual can be reached by mail after completion of the program. (Do not give present address unless it is considered permanent as defined above.)
Items 10-13. Race/Ethnicity/Disability/Disadvantaged Background. Responses to these items will help provide statistical information on the participation of individuals from diverse groups in Public Health Service (PHS) programs and identify inequities in terms of recruitment and retention based on race, ethnicity, disability and/or disadvantaged background.
Trainees, scholars, and participants are strongly encouraged to provide this information, however declining to do so will in no way affect their appointments.
This information will be retained by the PHS in accordance with and protected by the Privacy Act of 1974. Racial/ethnic/disability/background data are confidential and all analyses utilizing the data will report aggregate statistical findings only and will not identify individuals. (See the Privacy Act Statement at the end of these instructions for more information.)
10. Are you Hispanic (or Latino)?
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term, “Spanish origin,” can be used in addition to “Hispanic or Latino”.
11. What is your racial background?
Check one or more.
American Indian or Alaska Native. A person having origins in any of the original peoples of North, Central, or South America and maintains tribal affiliation or community.
Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American. A person having origins in any of the black racial groups of Africa. Terms such as “Haitian” or “Negro” can be used in addition to “Black or African American.”
Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
12. Do you have a disability?
Disability: A physical or mental impairment that substantially limits one or more major life activities.
13. Are you from a disadvantaged background?
Disadvantaged Background: An individual is considered to be from a disadvantaged background if he or she:
1. Comes from a family with an annual income below established low-income thresholds, published by the U.S. Bureau of the Census; adjusted annually for changes in the Consumer Price Index; and adjusted by the Secretary for use in all health professions programs. The Secretary periodically publishes these income levels at http://aspe.hhs.gov/poverty/ index.shtml. Individuals falling in this category must have qualified for Federal disadvantaged assistance or have received Health Professional Student Loans (HPSL), Loans for Disadvantaged Student Program, or scholarships from the U.S. Department of Health and Human Services under the Scholarship for Individuals with Exceptional Financial Need.
2. Comes from a social, cultural, or educational environment, such as that found in certain rural or inner-city environments, that has demonstrably and recently directly inhibited the acquisition of the knowledge, skills, and abilities necessary to develop and participate in a research career. This category is most applicable to high school and perhaps undergraduate students, but more difficult to justify for individuals beyond that level of achievement.
Item 14. Field of Training (FOT). Provide a single numeric FOT code from the list below that best fits the research training that will be provided during the appointment. Use the subcode (nonbold lowercase) unless the broader category (bold uppercase) fits best.
1000 I. Predominantly Non-Clinical or Lab-Based Research Training
1100 BIOCHEMISTRY
1110 Biological Chemistry
1120 Bioenergetics
1130 Enzymology
1140 Metabolism
1200 BIOENGINEERING
1210 Bioelectric/Biomagnetic
1220 Biomaterials
1230 Biomechanical Engineering
1240 Imaging
1250 Instrumentation and Devices
1260 Mathematical Modeling
1270 Medical Implant Science
1280 Nanotechnology
1290 Rehabilitation Engineering
1310 Tissue Engineering
1400 BIOPHYSICS
1410 Kinetics
1420 Spectroscopy
1430 Structural Biology
1440 Theoretical Biophysics
1500 BIOTECHNOLOGY
1510 Applied Molecular Biology
1520 Bioprocessing and Fermentation
1530 Metabolic Engineering
1600 CELL AND DEVELOPMENTAL BIOLOGY
1610 Cell Biology
1620 Developmental Biology
1700 CHEMISTRY
1710 Analytical Chemistry
1720 Bioinorganic Chemistry
1730 Bioorganic Chemistry
1740 Biophysical Chemistry
1750 Medicinal Chemistry
1760 Physical Chemistry
1770 Synthetic Chemistry
1900 ENVIRONMENTAL SCIENCES
2000 GENETICS
2010 Behavioral Genetics
2020 Developmental Genetics
2030 Genetic Epidemiology
2040 Genetics of Aging
2050 Genomics
2060 Human Genetics
2070 Molecular Genetics
2080 Population Genetics
2200 IMMUNOLOGY
2210 Asthma and Allergic Mechanisms
2220 Autoimmunity
2230 Immunodeficiency
2240 Immunogenetics
2250 Immunopathology
2260 Immunoregulation
2270 Inflammation
2280 Structural Immunology
2290 Transplantation Biology
2310 Vaccine Development
2400 MICROBIOLOGY AND INFECTIOUS DISEASES
2410 Bacteriology
2420 Etiology
2430 HIV/AIDS
2440 Mycology
2450 Parasitology
2460 Pathogenesis of Infectious Diseases
2470 Virology
2600 MOLECULAR BIOLOGY
2800 NEUROSCIENCE
2810 Behavioral Neuroscience
2820 Cellular neuroscience
2830 Cognitive neuroscience
2840 Communication Neuroscience
2850 Computational Neuroscience
2860 Developmental Neuroscience
2870 Molecular Neuroscience
2880 Neurochemistry
2890 Neurodegeneration
2910 Neuropharmacology
2920 Systems/Integrative Neuroscience
3100 NUTRITIONAL SCIENCES
3200 PHARMACOLOGY
3210 Molecular Pharmacology
3220 Pharmacodynamics
3230 Pharmacogenetics
3240 Toxicology
3300 PHYSIOLOGY
3310 Aging
3320 Anesthesiology (basic science)
3330 Endocrinology (basic science)
3340 Exercise Physiology (basic science)
3350 Integrative Biology
3360 Molecular Medicine
3370 Physiological Optics
3380 Reproductive Physiology
3500 PLANT BIOLOGY
3600 PSYCHOLOGY, NON-CLINICAL
3610 Behavioral Communication Sciences
3620 Behavioral Medicine (non-clinical)
3630 Cognitive Psychology
3640 Developmental and Child Psychology
3650 Experimental & General Psychology
3660 Mind-Body Studies
3680 Neuropsychology
3690 Personality and Emotion
3710 Physiological Psychology & Psychobiology
3720 Psychology of Aging
3730 Psychometrics
3740 Psychophysics
3750 Social Psychology
3900 PUBLIC HEALTH
3910 Disease Prevention and Control
3920 Epidemiology
3930 Health Economics
3940 Health Education
3950 Health Policy Research
3960 Health Services Research
3970 Occupational and Environmental Health
4100 RADIATION, NON-CLINICAL
4110 Nuclear Chemistry
4120 Radiation Physics
4130 Radiobiology
4200 SOCIAL SCIENCES
4210 Anthropology
4220 Bioethics
4230 Demography & Population Studies
4240 Economics
4250 Education
4260 Language and Linguistics
4270 Sociology
4400 STATISTICS AND/OR RESEARCH METHODS AND/OR INFORMATICS
4410 Biostatistics and/or Biometry
4420 Bioinformatics
4430 Computational Science
4440 Information Science
4450 Clinical Trials Methodology
4600 TRAUMA, NON CLINICAL
5000 OTHER, Predominantly Non-Clinical or Lab-Based Research Training
6000 II. Predominantly Clinical Research Training (can include any degree)
6100 ALLIED HEALTH
6110 Audiology
6120 Community Psychology
6130 Exercise Physiology (clinical)
6140 Medical Genetics
6150 Occupational Health
6160 Palliative Care
6170 Physical Therapy
6180 Pharmacy
6190 Social Work
6210 Speech-language Pathology
6211 Rehabilitation
6400 DENTISTRY
6500 CLINICAL DISCIPLINES
6510 Allergy
6520 Anesthesiology
6530 Behavioral Medicine (clinical)
6540 Cardiovascular Diseases
6550 Clinical Laboratory Medicine
6560 Clinical Nutrition
6570 Clinical Pharmacology
6580 Complementary and Alternative Medicine
6590 Clinical Psychology
6610 Connective Tissue Diseases
6620 Dermatology
6630 Diabetes
6640 Gastroenterology
6650 Endocrinology
6660 Immunology
6670 Gene Therapy (clinical)
6680 Geriatrics
6690 Hematology
6710 HIV/AIDS
6820 Infectious Diseases
6830 Liver Diseases
6840 Metabolic Diseases
6850 Nephrology
6860 Neurology
6870 Ophthalmology
6880 Nuclear Medicine
6890 OB-GYN
6910 Oncology
6920 Orthopedics
6930 Otorhinolarynology
6940 Preventive Medicine
6950 Radiation, Interventional
6960 Pulmonary Diseases
6970 Radiology, Diagnostic
6980 Rehabilitation Medicine
6990 Psychiatry
7110 Surgery
7120 Trauma
7130 Urology
7300 PEDIATRIC DISCIPLINES
7310 Pediatric Endocrinology
7320 Pediatric Hematology
7330 Pediatric Oncology
7340 Pediatric, Prematurity & Newborn
7500 NURSING
7700 VETERINARY MEDICINE
8000 OTHER, Predominantly Clinical Research Training
Item 15. Period of this Appointment. The period shown in most cases will be 12 months. Appointment periods may exceed 12 months in rare cases and only with prior approval from the PHS. The amount of the stipend/salary and tuition for each full period of appointment must be obligated from funds available at the time the appointment begins, unless other arrangements have been made with PHS.
Other instructions should be requested where institutional accounting practice precludes obligations of stipend/salary and tuition in the amount required for the full appointment period.
Item 16. Education. List undergraduate, master’s, and doctoral degrees and the month and year earned.
Item 17. Specialty Boards. If applicable, select a specialty from the attached list. If not applicable, indicate N/A.
Items 18-19. Degrees Sought. Provide the degree sought under the award. Indicate whether the appointee is in a dual degree program (e.g., M.D./Ph.D.).
Include the date that all degree requirements are expected to be completed.
Item 20. Support for Period of Appointment. Indicate the total amount the appointee expects to receive from the grant during the appointment period.
Item 21. Statement of Nondelinquency on U.S. Federal Debt. A “Statement of Nondelinquency on Federal Debt” is required for each particular appointment period and is to be completed by each individual (trainee) appointed to receive financial support under a PHS institutional training grant.
If the prospective trainee is delinquent on Federal debt, the PHS must review the explanation required to be provided on, or attached to, the form. In such case the PHS shall (a) take such information into account when determining whether the prospective trainee is responsible with respect to that appointment, and (b) consider not approving the appointment until payment is made or satisfactory arrangements are made with the agency to whom the debt is owed.
Therefore, it may be necessary for the PHS to contact the prospective trainee before the appointment can be approved to confirm the status of the debt and ascertain the payment arrangements for its liquidation. Individuals failing to liquidate indebtedness to the Federal Government in a businesslike manner place themselves at risk of not receiving PHS financial assistance.
The PHS awarding component shall notify the sponsoring institution in writing of its decision regarding the approval of a prospective appointee where this form discloses delinquency on Federal debt.
The trainee must check the appropriate box. If the “Yes” box is checked, please provide an explanation in the space provided. The question applies only to the person requesting financial assistance, and does not apply to the person who signs the form as the Program Director.
Examples of Federal Debt include delinquent taxes, audit disallowances, guaranteed or direct student loans, FHA loans, business loans, and other miscellaneous administrative debts. For purposes of this certification, the following definitions of “delinquency” apply:
• For direct loans and fellowships (whether awarded directly to the applicant by the Federal Government or by an institution using Federal funds), a debt more than 31 days past due on a scheduled financial payment. (This definition excludes service payback under a National Research Service Award.)
• For guaranteed and insured loans, recipients of a loan guaranteed by the Federal Government that the Federal Government has repurchased from a lender because the borrower breached the loan agreement and is in default.
• For grants, organizations in receipt of a “Notice of Grants Cost Disallowance” which have not repaid the disallowed amount or which have not resolved the disallowance. (This definition excludes disallowance in an “appeal” status.)
Item 22. Certification and Signature of Appointee. Self-explanatory.
Item 23. Certification, Signature, and Address of Program Director. Self-explanatory.
Form Approved Through 9/30/2010 OMB No. 0925-0001 |
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Department of Health and Human Services Public Health Services Statement of Appointment(Please Type) |
Follow attached instructions carefully. Submit this form at the time the individual is appointed, is reappointed, or the reported appointment is amended. Return this form to the PHS awarding component. For new postdoctoral trainees under NRSA, signed and dated payback agreement must accompany this form. |
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1. PHS GRANT NUMBER |
2. APPOINTEE’S NAME (Last, first, initial) |
3. SEX
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Type
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Activity
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ID Serial No.
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M F |
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4. TYPE OF ACTION (Check only one type)
NEW appointment (NOT previously supported by this grant)
REAPPOINTMENT (Previously supported by this grant)
AMENDMENT of items checked: 2 9 15 20 |
5. PRIOR NRSA SUPPORT (Individual or institutional)
NO YES (If “Yes,” see instructions) |
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6. SOCIAL SECURITY NO. XXX-XX- |
7. BIRTHDATE (Month, day, year)
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8. CITIZENSHIP (See instructions)
U.S. Citizen or Noncitizen National
Non-U.S. Citizen
With a Permanent U.S. Resident Visa (“Green Card”) With a Temporary U.S. Visa
If not a U.S. citizen, of which country are you a citizen?
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9. PERMANENT MAILING ADDRESS
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10. Are you Hispanic (or Latino)? YES NO Do Not Wish to Provide |
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11. What is your racial background? Check one or more
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Asian
Black or African American
White
Do Not Wish to Provide |
12. Do you have a disability? |
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YES NO Do Not Wish to Provide |
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If yes, which of the following categories describe your disability(ies): |
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Hearing |
Mobility/Orthopedic Impairment |
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Visual |
Other |
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13. Are you from a disadvantaged background? |
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YES NO Do Not Wish to Provide |
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14. FIELD OF RESEARCH TRAINING OR CAREER DEVELOPMENT (for this appointment) |
15. PERIOD OF APPOINTMENT (Month, day, year) |
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Enter a 4 digit code from instructions: |
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From: |
To: |
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16. EDUCATION – AFTER HIGH SCHOOL (Indicate all academic and professional education. For foreign degrees, give U.S. equivalent.) |
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(a) Name of Institution and Location (List most recent first) |
(b) Degree(s) Received |
(c) Major Field |
(d) Minor Field |
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Degree |
Mo./Yr. |
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PHS 2271 (Rev. 9/2007) Page 1 of 2
17. NAME OF SPECIALTY BOARDS (if applicable)
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18. DEGREE(S) SOUGHT YES NO |
If yes, indicate type |
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Are you in a dual degree program (e.g., M.D./Ph.D.)? YES NO |
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19. EXPECTED COMPLETION DATE OF DEGREE REQUIREMENTS (if applicable) |
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20. SUPPORT FOR PERIOD OF APPOINTMENT |
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TYPE |
Total for this Grant (Omit cents) |
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Stipend / Salary / Other Compensation |
$ |
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Tuition/fees (estimated) |
$ |
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Travel (estimated) |
$ |
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TOTAL |
$ |
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21. STATEMENT OF NONDELINQUENCY ON U.S. FEDERAL DEBT. Is the appointee delinquent on the repayment of any U.S. Federal debt(s)? |
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NO YES (If “Yes,” please explain below.) |
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22. CERTIFICATION AND ACCEPTANCE: I certify that the statements herein are true and complete to the best of my knowledge and that I will comply with all applicable Public Health Service terms and conditions governing my appointment. I am aware that any false, fictitious or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. |
(a) SIGNATURE OF APPOINTEE |
(b) DATE |
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23. This individual is qualified for this program and is eligible to receive financial support for the period specified above. A copy of this appointment form will be given to the individual. |
(a) SIGNATURE OF PROGRAM DIRECTOR |
(b) DATE |
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(c) TYPED NAME OF PROGRAM DIRECTOR |
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(d) INSTITUTION’S NAME, ADDRESS, AND PHONE NO. (Street, city, state, zip code) |
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PHS 2271 (Rev. 9/2007) Page 2 of 2
The PHS maintains application and grant records as part of a system of records as defined by the Privacy Act: 09-25-0112, Grants and Cooperative Agreements: Research, Research Training, Fellowship, and Construction Applications and Related Awards. The Privacy Act of 1974 (5 USC 522a) allows disclosures for “routine uses” and permissible disclosures.
Some routine uses may be:
1. To the cognizant audit agency for auditing.
2. To a Congressional office from a record of an individual in response to an inquiry from the Congressional office made at the request of that individual.
3. To qualified experts, not within the definition of DHHS employees as prescribed in DHHS regulations (45 CFR 5b.2) for opinions as part of the application review process.
4. To a Federal agency, in response to its request, in connection with the letting of a contract or the issuance of a license, grant, or other benefit by the requesting agency, to the extent that the record is relevant and necessary to the requesting agency’s decision on the matter;
5. To organizations in the private sector with whom PHS has contracted for the purpose of collating, analyzing, aggregating, or otherwise refining records in a system. Relevant records will be disclosed to such a contractor, who will be required to maintain Privacy Act safeguards with respect to such records.
6. To the sponsoring organization in connection with the review of an application or performance or administration under the terms and conditions of the award, or in connection with problems that might arise in performance or administration if an award is made.
7. To the Department of Justice, to a court or other tribunal, or to another party before such tribunal, when one of the following is a party to litigation or has any interest in such litigation, and the DHHS determines that the use of such records by the Department of Justice, the tribunal, or the other party is relevant and necessary to the litigation and would help in the effective representation of the governmental party.
a. the DHHS, or any component thereof;
b. any DHHS employee in his or her official capacity;
c. any DHHS employee in his or her individual capacity where the Department of Justice (or the DHHS, where it is authorized to do so) has agreed to represent the employee; or
d. the United States or any agency thereof; where the DHHS determines that the litigation is likely to affect the DHHS or any of its components.
8. A record may also be disclosed for a research purpose, when the DHHS:
a. has determined that the use or disclosure does not violate legal or policy limitations under which the record was provided, collected, or obtained;
b. has determined that the research purpose (1) cannot be reasonably accomplished unless the record is provided in individually identifiable form, and (2) warrants the risk to the privacy of the individual that additional exposure of the record might bring;
c. has secured a written statement attesting to the recipient’s understanding of; and willingness to abide by, these provisions; and
d. has required the recipient to:
(1) establish reasonable administrative, technical, and physical safeguards to prevent unauthorized use or disclosure of the record;
(2) destroy the information that identifies the individual at the earliest time at which removal or destruction can be accomplished consistent with the purpose of the research project, unless the recipient has presented adequate justification of a research or health nature for retaining such information; and
(3) make no further use or disclosure of the record, except (a) in emergency circumstances affecting the health or safety of any individual, (b) for use in another research project, under these same conditions, and with written authorization of the DHHS, (c) for disclosure to a properly identified person for the purpose of an audit related to the research project, if information that would enable research subjects to be identified is removed or destroyed at the earliest opportunity consistent with the purpose of the audit, or (d) when required by law.
The Privacy Act also authorizes discretionary disclosures where determined appropriate by the PHS, including to law enforcement agencies, to the Congress acting within its legislative authority, to the Bureau of the Census, to the National Archives, to the General Accounting Office, pursuant to a court order, or as required to be disclosed by the Freedom of Information Act of 1974(5 USC 552) and the associated DHHS regulations (45 CFR Part 5).
PHS 2271 (Rev. 9/2007) — Instructions
File Type | application/msword |
File Title | PHS 2271 (Rev. 9/2007), Statement of Training Appointment |
Subject | DHHS, Public Health Services |
Author | DHHS, Public Health Services |
Last Modified By | curriem |
File Modified | 2007-09-14 |
File Created | 2007-09-14 |