PHS Applications and Pre-award Related Reporting (OD)

Forms and Documents

Document	Type	Status	Availability
Form 1 PHS 398 Paper	Form and Instruction	Unchanged	Available
Form 1 PHS 416-5	Form and Instruction	Unchanged	Repair queued
Form 1 SBIR/STTR Funding Agreement Certification	Form and Instruction	Unchanged	Repair queued
Form 1 VCOC Certification	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 6031	Form and Instruction	Unchanged	Repair queued
Form 1 416-1	Form and Instruction	Unchanged	Repair queued
Form 1 Biosketch (Fellowship)	Form and Instruction	Unchanged	Repair queued
Form 1 PHS Inclusion Enrollment Report	Form and Instruction	Unchanged	Repair queued
Form 1 PHS Fellowship Supplemental Form (includes F reference letters)	Form and Instruction	Unchanged	Repair queued
Form 1 Biosketch (424 Electronic)	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 398 Career Development Award Supplemental Form	Form and Instruction	Unchanged	Repair queued
Form 1 Data Tables	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 398 Research Training Program Plan	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 398 Research Plan	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 398 Training Subaward Budget Attachment(s) Form	Form and Instruction	Unchanged	Available
Form 1 PHS 398 Training Budget	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 398 Modular Budget	Form and Instruction	Unchanged	Repair queued
Form 1 PHS Inclusion Enrollment Report	Form and Instruction	Unchanged	Repair queued
Form 1 PHS 398 Cover Page Supplement	Form and Instruction	Unchanged	Repair queued
Form 1 PHS Assignment Request Form	Form and Instruction	Unchanged	Repair queued
AttC Prior Approval Screen Shots.docx	Supplementary Document	Uploaded 2016-11-10	Repair queued
AttB Revised Appendix Instructions.docx	Supplementary Document	Uploaded 2016-11-10	Repair queued
AttA Revised Biosketch Instructions.docx	Supplementary Document	Uploaded 2016-11-10	Repair queued
OMB Change Request Memo to OMB - 0925-0001 - November 2016.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-11-10	Repair queued
Attachment 11G International Training Tables.docx	Supplementary Document	Uploaded 2016-03-01	Available
11B International Training Tables FINAL DRAFT track changes.docx	Supplementary Document	Uploaded 2016-03-01	Available
OMB Change Request for DITR Tables-2.docx	Supplementary Document	Uploaded 2016-03-01	Repair queued
AttB Revised Biosketch Instructions.docx	Supplementary Document	Uploaded 2016-02-26	Repair queued
AttA Justification for Selected Instructions in 0925-0001 2.26.16.docx	Supplementary Document	Uploaded 2016-02-26	Available
0925-0001 Change Request Memo to OMB - 2.26.2016 sh.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2016-02-26	Repair queued
Attachment 1 Former Revised and New Content of Information Collections 10.2015.docx	Supplementary Document	Uploaded 2015-10-06	Repair queued
Supporting Statement A for 0925-0001 October 2015 ver5 FINAL 10062015.docx	Supporting Statement A	Uploaded 2015-10-06	Repair queued
Attachment 1 Former and Revised Content of Information Collections.docx	Supplementary Document	Uploaded 2015-07-28	Repair queued
Attachment 15 eRA Commons Profile Data Elements.xlsx	Supplementary Document	Uploaded 2015-07-20	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
37814	PHS 398 Paper	Form and Instruction	Unchanged
217591	PHS 416-5	Form and Instruction	Unchanged
217570	SBIR/STTR Funding Agreement Certification	Form and Instruction	Unchanged
217569	VCOC Certification	Form and Instruction	Unchanged
217568	PHS 6031	Form and Instruction	Unchanged
217567	416-1	Form and Instruction	Unchanged
217566	Biosketch (Fellowship)	Form and Instruction	Unchanged
217565	PHS Inclusion Enrollment Report	Form and Instruction	Unchanged
217564	PHS Assignment Request Form	Instruction	Unchanged
217563	PHS Fellowship Supplemental Form (includes F reference letters)	Form and Instruction	Unchanged
217561	Biosketch (424 Electronic)	Form and Instruction	Unchanged
217560	PHS 398 Career Development Award Supplemental Form	Form and Instruction	Unchanged
217559	Data Tables	Form and Instruction	Unchanged
217558	PHS 398 Research Training Program Plan	Form and Instruction	Unchanged
217557	PHS 398 Research Plan	Form and Instruction	Unchanged
217556	PHS 398 Training Subaward Budget Attachment(s) Form	Form and Instruction	Unchanged
217555	PHS 398 Training Budget	Form and Instruction	Unchanged
202980	PHS 398 Modular Budget	Form and Instruction	Unchanged
202979	PHS Inclusion Enrollment Report	Form and Instruction	Unchanged
202963	PHS 398 Cover Page Supplement	Form and Instruction	Unchanged
202959	PHS Assignment Request Form	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0925-0001	ICR Reference No: 201611-0925-001
Status: Historical Active	Previous ICR Reference No: 201603-0925-002
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: 11/15/2016
	Date Received in OIRA: 11/15/2016
Terms of Clearance: All materials distributed to respondents (online and paper) must clearly display the approved OMB control number, expiration date, and respective burden hours for the information collections.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2018	10/31/2018	10/31/2018
Responses	420,101	0	420,101
Time Burden (Hours)	850,756	0	850,756
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 and Ruth L. Kirschstein National Research Service Award (NRSA) Applications and Related Forms (0925-0001). 0925-0001 will expire on August 31, 2015. This 0925-0001 revision submission consolidates application and other related pre-award reporting requirements previously collected under 0925-0001. Post-award reporting requirements, including the Research Performance Progress Report (RPPR), are similarly consolidated and concurrently submitted under 0925-0002 (expiration August 31, 2015).

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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
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 13567	03/16/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 46591	08/05/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 21

IC Title	Form No.	Form Name
PHS 416-5	1	Individual Fellowship Activation Notice
PHS 398 Training Subaward Budget Attachment(s) Form	1	Attachment 5M PHS 398 Training Subaward Budget Attachment(s) Form
PHS 398 Research Plan	1	Attachment 5O PHS 398 Research Plan Form
PHS 398 Paper	2, 1	PHS 398 Paper Application ,   PHS 398 Paper Application
PHS Assignment Request Form	2, 1	Attachment 5C PHS Assignment Request Form ,   PHS Assignment Request Instruction
PHS 398 Cover Page Supplement	1, 2	Attachment 5E PHS 398 Cover Page Supplement Form ,   Attachment 5D PHS 398 Cover Page Supplement Instructions
PHS Inclusion Enrollment Report	1, 2	Attachment 5G PHS Inclusion Enrollment Report ,   Attachment 5F PHS Inclusion Enrollment Report Instructions
PHS 398 Modular Budget	1, 2	Attachment 5I PHS 398 Modular Budget Form ,   Attachment 5H PHS 398 Modular Budget Instructions
PHS 398 Training Budget	1, 2	Attachment 5K PHS 398 Training Budget Form ,   Attachment 5J PHS 398 Training Budget Instructions
Data Tables	3, 1	Data Tables ,   Introduction to the Data Tables
Biosketch (424 Electronic)	1	General Biographical Sketch Format Page
PHS 6031	1	PHS 6031
PHS 398 Career Development Award Supplemental Form	1	Career Development Supplemental Form
PHS Fellowship Supplemental Form (includes F reference letters)	1	Fellowship Supplemental Form
PHS Assignment Request Form	1	Attachment 5C PHS Assignment Request Form
PHS Inclusion Enrollment Report	1	Attachment 5G PHS Inclusion Enrollment Report
Biosketch (Fellowship)	1	Fellowship Applicant Biographical Format Page
PHS 398 Research Training Program Plan	1	Attachment 5S PHS 398 Research Training Program Plan Form
416-1	1, 2, 3, 4, 6, 5	Attachment 7B PHS 416-1 Face Page 1 ,   Attachment 7C PHS 416-1 Face Page 2 ,   Attachment 7D PHS 416-1 Face Page 3 ,   Attachment 7E PHS 416-1 Face Page 4 ,   Attachment 7F PHS 416-1 Checklist Form Page ,   Attachment 7G PHS 416-1 Continuation Page
VCOC Certification	1	VCOC Certification
SBIR/STTR Funding Agreement Certification	1, 2	SBIR Funding Agreement Certification ,   STTR Funding Agreement Certification

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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	420,101	420,101	0	0	0	0
Annual Time Burden (Hours)	850,756	850,756	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: This submission represents program changes; previous estimated total burden hours for 0925-0001 were 2,051,794; current estimated total burden hours for 0925-0001 is 850,756. This represents a decrease of 1,201,038 hours since the last approval. Although there has been an increase in application submissions, a recalculation of all pre-award burden hours that are broken up by individual form has allowed for a more accurate reflection of the burden placed on the respondents. Overall, the burden hour estimates for PHS forms did not change.

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Annual Cost to Federal Government: $46,070

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: 11/15/2016

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