Cancer Prevention Fellowship Program Fellowship Program and Summer Curriculum Applications (NCI)

Forms and Documents

Document	Type	Status	Availability
Form 3 CPFP Summer Curriculum Application	Form and Instruction	New	Available
Form 2 Reference Recommendation Letters	Form and Instruction	New	Repair queued
Form 1 CPFP Fellowship Application	Form and Instruction	New	Repair queued
30-Day FRN CPFP.pdf	Supplementary Document	Uploaded 2016-09-08	Available
Attachment 5 PIA.pdf	Supplementary Document	Uploaded 2016-08-31	Available
Attachment 4 Privacy Act Memo.pdf	Supplementary Document	Uploaded 2016-08-31	Available
SSA CPFP Final.docx	Supporting Statement A	Uploaded 2016-08-31	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
223281	CPFP Summer Curriculum Application	Form and Instruction	New
223280	Reference Recommendation Letters	Form and Instruction	New
223279	CPFP Fellowship Application	Form and Instruction	New

ICR Details

OMB Control No: 0925-0749	ICR Reference No: 201608-0925-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Cancer Prevention Fellowship Program Fellowship Program and Summer Curriculum Applications (NCI)
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/21/2016
	Date Received in OIRA: 09/09/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved
Responses	400	0	0
Time Burden (Hours)	400	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The proposed information collection involves brief online applications completed by applicants to the full time and the summer curriculum programs. Full-time fellowships include: non-FTE fellowships for US citizens and permanent residents and fellows that are part of the Irish Consortia. These applications are essential to the administration of these training programs as they enable CPFP to determine the eligibility and quality of potential awardees; to assess their potential as future scientists; to determine where mutual research interests exist; and to make decisions regarding which applicants will be proposed and approved for traineeship awards.

---

Authorizing Statute(s): US Code: 42 USC sections 241 and 282(b)(13) Name of Law: Public Health Service
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 39679	06/17/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 62156	09/08/2016
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
CPFP Fellowship Application	1	CPFP Application Screenshot
Reference Recommendation Letters	2	Contributor Screenshot
CPFP Summer Curriculum Application	3	Summer Curriculum Screenshot

---

ICR Summary 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	400	0	0	400	0	0
Annual Time Burden (Hours)	400	0	0	400	0	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: No

Burden Reduction Due to:

Short Statement: New - existing without OMB approval

---

Annual Cost to Federal Government: $91,376

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

---

Common Form ICR:  No

---

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: 09/09/2016

---