Information Collection

Program of Assistance for University-Based Training

IC 191580 under ICR 200912-0990-002 · OMB 0990-0352.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Program of Assistance for University-Based Training	Form and Instruction
1 Program of Assistance for University-Based Training Appl ONC 3016 PRA Application for University-Based Training FOA v2- IC.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form?

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Program of Assistance for University-Based Training Application Form	ONC 3016 PRA Application for University-Based Training FOA v2- IC.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	11,010	11,010
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.