Individual Ruth L. Kirschstein National Research Service Award Applications and Related Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3 RPPR	Form	Modified	Available
Form 2 PHS 416-9	Form and Instruction	Modified	Available
Form 1 PHS 2590	Form	Modified	Available
Form 1 phs 3734	Form and Instruction	New	Available
Form 1 HHS 568	Form and Instruction	New	Available
Form 1 Final Progress report	Form and Instruction	Modified	Available
Form 1 HHS 568	Form and Instruction	Modified	Available
Form 1 6031-1	Form and Instruction	Modified	Available
Form 1 PHS 2271	Form and Instruction	Modified	Available
Form 1 PHS 416-7	Form and Instruction	Modified	Available
Form 13 form	Form	Removed	Available
Form 17 416-1	Form and Instruction	Removed	Available
Form 18 form	Form	Removed	Available
Form 16 form	Form and Instruction	Removed	Available
Form 15 form	Form and Instruction	Removed	Available
Form 14 form	Form and Instruction	Removed	Available
Form 1 form	Form and Instruction	Removed	Available
Form 11 form	Form and Instruction	Removed	Available
Form 10 form	Form and Instruction	Removed	Available
Form 9 form	Form and Instruction	Removed	Available
Form 7 form	Form and Instruction	Removed	Available
Form 19 form	Form and Instruction	Removed	Available
Form 5 form	Form and Instruction	Removed	Available
Form 4 form	Form and Instruction	Removed	Available
Form 3 form	Form	Removed	Available
Form 2 form	Form and Instruction	Removed	Available
Form 8 form	Form and Instruction	Removed	Available
Form 6 form	Form and Instruction	Removed	Available
Attachment 2 - CFDA.xlsx	Supplementary Document	Uploaded 2012-06-30	Available
Attachment 1 Former and Revised Content of Information Collections.docx	Supplementary Document	Uploaded 2012-06-30	Available
Supporting Statement for 0925-0002 June 2012.docx	Supporting Statement A	Uploaded 2012-06-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7244	RPPR (or 2590 or 416-9)	Form	Modified	RPPR
7244	RPPR (or 2590 or 416-9)	Form and Instruction	Modified	PHS 416-9
7244	RPPR (or 2590 or 416-9)	Instruction	Modified
7244	RPPR (or 2590 or 416-9)	Form	Modified	PHS 2590
202949	PHS 3734	Form and Instruction	New	phs 3734
202948	iEdison	Form and Instruction	New	HHS 568
186008	PHS 6031-1	Form and Instruction	Modified	Final Progress report
186007	PHS 568	Form and Instruction	Modified	HHS 568
186006	416-7	Form and Instruction	Modified	6031-1
186005	PHS 2271	Form and Instruction	Modified	PHS 2271
186004	416-7	Form and Instruction	Modified	PHS 416-7
186003	416-1	Form	Removed	form
186003	416-1	Form and Instruction	Removed	416-1
186003	416-1	Form	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form
186003	416-1	Form and Instruction	Removed	form

ICR Details

OMB Control No: 0925-0002	ICR Reference No: 201206-0925-006
Status: Historical Active	Previous ICR Reference No: 201102-0925-008
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Individual Ruth L. Kirschstein National Research Service Award Applications and Related Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/06/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/30/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	08/31/2012
Responses	112,986	0	29,467
Time Burden (Hours)	661,549	0	130,703
Cost Burden (Dollars)	0	0	0

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Abstract: National Institutes of Health and other Public Health Service grantees are required to submit interim and final progress reports and other post-award documents associated with the monitoring, oversight, and closeout of an award. This submission represents a consolidation of post-award reporting requirements into a revised data collection under the Paperwork Reduction Act, referred to here as 0925-0002 (previously known as Individual Ruth L. Kirschstein National Research Service Award Applications and Related Forms). The collection includes post-award reporting requirements previously collected under 0925-0001 and 0925-0002. Application and other pre-award related forms are similarly consolidated and concurrently submitted under 0925-0001.

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Authorizing Statute(s): US Code: 42 USC 288 Name of Law: National Research Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 17488	03/26/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 38843	06/29/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
416-1	17, 8, 2, 3, 4, 5, 6, 19, 7, 9, 10, 11, 1, 14, 15, 16, 18, 13	form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   form ,   416-1 ,   form
416-7	1	6031-1
416-7	1	PHS 416-7
PHS 2271	1	PHS 2271
PHS 3734	1	phs 3734
PHS 568	1	HHS 568
PHS 6031-1	1	Final Progress report
RPPR (or 2590 or 416-9)	1, 2, 3	PHS 2590 ,   PHS 416-9 ,   RPPR
iEdison	1	HHS 568

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	112,986	29,467	0	87,219	-3,700	0
Annual Time Burden (Hours)	661,549	130,703	0	541,371	-10,525	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: This submission represents program changes; previous estimated total burden hours for 0925-0002 was 132,501, current estimated total burden hours for 0925-0002 is 640,677. The increase of 508,176 is attributed to the reconfiguration of 0925-0001 and 0925-0002 into pre- and post-award forms as detailed in Attachment 1.

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Annual Cost to Federal Government: $1,500,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/30/2012

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