Information Collection

Biosketch (424 Electronic)

IC 217561 under ICR 201602-0925-016 · 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⚠️ Notice: This information collection may be referencing outdated material.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 1 Biosketch (424 Electronic)	Form and Instruction
Attachment 9B General Biographical Sketch Instructions and Sample.docx	Instruction
1 General Biographical Sketch Format Page Attachment 9A General Biographical Sketch Format Page.docx	Form and Instruction

IC Title:

Biosketch (424 Electronic)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	1	General Biographical Sketch Format Page	Attachment 9A General Biographical Sketch Format Page.docx		Yes	Yes	Fillable Fileable
Instruction			Attachment 9B General Biographical Sketch Instructions and Sample.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80,946

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	80,946	80,946
Annual IC Time Burden (Hours)	161,892	161,892
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.