Information Collection

PHS Fellowship Supplemental Form (electronic)

IC 202959 under ICR 201206-0925-007 · OMB 0925-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6A PHS Fellowship Supplemental Form (electronic)	Form and Instruction
6A PHS 398 Fellowship Supplemental Form Attachment 6A PHS 398 Fellowship Supplemental Form Instructions.doc	Form and Instruction
6B Fellowship Supplemental Form Attachment 6B PHS 398 Fellowship Supplemental Form.pdf	Form and Instruction

IC Title:

PHS Fellowship Supplemental Form (electronic)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	6A	PHS 398 Fellowship Supplemental Form	Attachment 6A PHS 398 Fellowship Supplemental Form Instructions.doc		Yes	Yes	Fillable Fileable
Form and Instruction	6B	Fellowship Supplemental Form	Attachment 6B PHS 398 Fellowship Supplemental Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,915

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	4,915	4,915
Annual IC Time Burden (Hours)	78,640	78,640
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.