Public Health Agency or Organization

Fellowship Management System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0765 can be found here:

Documents and Forms

Document Name Document Type
FMS_Attachment 3_FMS Host Site Assignment Prop Esample PHAP HSAP.docx Instruction

Information Collection (IC) Details

IC Title:	Public Health Agency or Organization	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			FMS_Attachment 3_FMS Host Site Assignment Prop Esample PHAP HSAP.docx		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 226	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	226	226
Annual IC Time Burden (Hours)	339	339
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.