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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

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.