PHS Applications and Pre-award Related Reporting (OD)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3B NRSA Data Table Format	Form	Unchanged	Available
Form 3A Paper Application Form	Form	Unchanged	Available
Form Attachment 10 Payment Agreement	Form and Instruction	Unchanged	Repair queued
Form Attachment 9 Fellowship Activation Notice	Form and Instruction	Unchanged	Repair queued
Form 7C Face Page 2	Form and Instruction	Unchanged	Available
Form 7H Continuation Page	Form and Instruction	Unchanged	Available
Form 7G Checklist Form Page	Form and Instruction	Unchanged	Repair queued
Form 7F SPONSOR/CO-SPONSOR BIOGRAPHICAL SKETCH	Form and Instruction	Unchanged	Available
Form 7E Face Page 4	Form and Instruction	Unchanged	Available
Form 7D Project Performance Site Format	Form and Instruction	Unchanged	Available
Form 7C Face Page 3	Form and Instruction	Unchanged	Repair queued
Form 7B Face Page	Form and Instruction	Unchanged	Available
Form New Fellowship Biosketch format form	Form and Instruction	Unchanged	Available
Form 6B PHS Fellowship Supplemental Form	Form and Instruction	Unchanged	Available
Form 6A Completing PHS Fellowship Specific Components	Form and Instruction	Unchanged	Available
Form 5G PHS 398 Research Training Plan Form	Form and Instruction	Unchanged	Available
Form 5F Supplemental Instructions for Preparing an Institutional Ruth L. Kirschstein National Research Service Award (NRSA) Application	Form and Instruction	Unchanged	Available
Form 5E PHS 398 Career Development Form	Form and Instruction	Unchanged	Available
Form 5D Supplemental Instructions for Preparing an Individual Research Career Development Award Application ("K" Series)	Form and Instruction	Unchanged	Repair queued
Form 5C PHS 398 Research Plan	Form and Instruction	Unchanged	Available
Form 5B Completing PHS 398 Components	Form and Instruction	Unchanged	Available
Form 5A Components of an Application to NIH or Other PHS Agencies	Form and Instruction	Unchanged	Available
Proposed New Fellowship Applicant Biosketch without track changes 9-19-14 JS.docx	Supplementary Document	Uploaded 2014-09-26	Available
SF424R-R_biosketchsample_VerC_20140723_2014_Revision without track changes Sept 2014 WS.docx	Supplementary Document	Uploaded 2014-09-26	Available
Fellowship Applicant.Biosketch Sample-Final 9-19-14 JS.docx	Supplementary Document	Uploaded 2014-09-26	Available
Biosketch Instructions for All Users without track changes 9-19-14 JS.docx	Supplementary Document	Uploaded 2014-09-26	Available
0925-0001 Change Request Memo to OMB - 9 26 2014 FINAL.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2014-09-26	Available
0001 Biosketch Change Request Memo 5.1.2014.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2014-05-01	Repair queued
0925-0001 Attachement E--eRA Commons Profile Data Elements Revised (2).xls	Supplementary Document	Uploaded 2013-06-13	Available
0925-0001 Attachment D--personal profile screen shots OPERA.pdf	Supplementary Document	Uploaded 2013-06-13	Available
0925-0001 Attachment C--Biosketch Changes.doc	Supplementary Document	Uploaded 2013-06-13	Available
0925-0001 Attachment B--PHS 398 Instructions Revision.doc	Supplementary Document	Uploaded 2013-06-13	Available
0925-0001 Attachment A--Changes to Supplemental Grant Application Instruction Clean Version 5.31.2013.doc	Supplementary Document	Uploaded 2013-06-13	Available
Change Request Justification for Selected Instructions in 0925-0001 6.12.2013 REVISED.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2013-06-13	Available
0925-0001 Change Request Memo to OMB - 6.12.2013 REVISED.doc	Supplementary Document	Uploaded 2013-06-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
37814	398 Forms and Instructions (Paper)	Instruction	Unchanged
37814	398 Forms and Instructions (Paper)	Form	Unchanged	NRSA Data Table Format
37814	398 Forms and Instructions (Paper)	Form	Unchanged	Paper Application Form
202980	6031	Form and Instruction	Unchanged	Payment Agreement
202979	416-5	Form and Instruction	Unchanged	Fellowship Activation Notice
202963	416-1	Form and Instruction	Unchanged	Face Page 2
202963	416-1	Form and Instruction	Unchanged	Continuation Page
202963	416-1	Form and Instruction	Unchanged	Checklist Form Page
202963	416-1	Form and Instruction	Unchanged	SPONSOR/CO-SPONSOR BIOGRAPHICAL SKETCH
202963	416-1	Form and Instruction	Unchanged	Face Page 4
202963	416-1	Form and Instruction	Unchanged	Project Performance Site Format
202963	416-1	Form and Instruction	Unchanged	Face Page 3
202963	416-1	Form and Instruction	Unchanged	Face Page
202963	416-1	Instruction	Unchanged
202959	PHS Fellowship Supplemental Form (electronic)	Form and Instruction	Unchanged	Fellowship Biosketch format form
202959	PHS Fellowship Supplemental Form (electronic)	Form and Instruction	Unchanged	PHS Fellowship Supplemental Form
202959	PHS Fellowship Supplemental Form (electronic)	Form and Instruction	Unchanged	Completing PHS Fellowship Specific Components
182171	398 Forms and Instructions (Electronic)	Instruction	Unchanged
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	PHS 398 Research Training Plan Form
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	Supplemental Instructions for Preparing an Institutional Ruth L. Kirschstein National Research Service Award (NRSA) Application
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	PHS 398 Career Development Form
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	Supplemental Instructions for Preparing an Individual Research Career Development Award Application ("K" Series)
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	PHS 398 Research Plan
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	Completing PHS 398 Components
182171	398 Forms and Instructions (Electronic)	Form and Instruction	Unchanged	Components of an Application to NIH or Other PHS Agencies

ICR Details

OMB Control No: 0925-0001	ICR Reference No: 201409-0925-006
Status: Historical Active	Previous ICR Reference No: 201405-0925-001
Agency/Subagency: HHS/NIH	Agency Tracking No: 19797
Title: PHS Applications and Pre-award Related Reporting (OD)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/07/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/26/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	08/31/2015	08/31/2015
Responses	94,326	0	94,326
Time Burden (Hours)	2,051,794	0	2,051,794
Cost Burden (Dollars)	0	0	0

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Abstract: The National Institutes of Health (NIH) and other Public Health Service (PHS) agencies currently use the Research and Research Training Grant Applications and Related Forms (0925-0001) and Ruth L. Kirschstein National Research Service Award (NRSA) Applications and Related Forms (0925-0002). Both 0925-0001 and 0925-0002 will expire on June 30, 2012. In 2009, application and pre-award related forms were simultaneously submitted under both 0925-0001 and 0925-0002. This 0925-0001 submission consolidates application and other related pre-award reporting requirements previously collected under 0925-0001 and 0925-002. Post-award reporting requirements previously collected under 0925-0001 and 0925-0002, and the New Research Performance Progress Report (RPPR), are similarly consolidated and concurrently submitted under 0925-0002.

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Authorizing Statute(s): US Code: 42 USC 285 Name of Law: public Health Serice Act
   US Code: 42 USC 286 Name of Law: Public Health Service Act
   US Code: 42 USC 300 Name of Law: Public Health Service Act
   US Code: 42 USC 288 Name of Law: Public Health Serive Act
   US Code: 42 USC 216 Name of Law: Public health Service Act
   US Code: 42 USC 241 Name of Law: Public Health Service
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
398 Forms and Instructions (Electronic)	5A, 5B, 5C, 5D, 5E, 5F, 5G	Components of an Application to NIH or Other PHS Agencies ,   Completing PHS 398 Components ,   PHS 398 Research Plan ,   Supplemental Instructions for Preparing an Individual Research Career Development Award Application ("K" Series) ,   PHS 398 Career Development Form ,   Supplemental Instructions for Preparing an Institutional Ruth L. Kirschstein National Research Service Award (NRSA) Application ,   PHS 398 Research Training Plan Form
398 Forms and Instructions (Paper)	3A, 3B	Paper Application Form ,   NRSA Data Table Format
416-1	7B, 7C, 7D, 7E, 7F, 7G, 7H, 7C	Face Page ,   Face Page 3 ,   Project Performance Site Format ,   Face Page 4 ,   SPONSOR/CO-SPONSOR BIOGRAPHICAL SKETCH ,   Checklist Form Page ,   Continuation Page ,   Face Page 2
416-5	Attachment 9	Fellowship Activation Notice
6031	Attachment 10	Payment Agreement
PHS Fellowship Supplemental Form (electronic)	6A, 6B, New	Completing PHS Fellowship Specific Components ,   PHS Fellowship Supplemental Form ,   Fellowship Biosketch format form

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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	94,326	94,326	0	0	0	0
Annual Time Burden (Hours)	2,051,794	2,051,794	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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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: 09/26/2014

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