Information Collection

Fellowship Placement Pilot Program

IC 198093 under ICR 201106-2528-002 · OMB 2528-0273.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2528-0273 can be found here:

Documents and Forms

Document Name Document Type
Fellowship Placement Pilot Program Form and Instruction
Application for Fellowship Program for Fellows Application for Fellowship Program for Fellows.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Fellowship Placement Pilot Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Application for Fellowship Program for Fellows	Application for Fellowship Program for Fellows.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.