OMB
.report
Search
DIR Grant Reviewer Recruitment Form
Grant Reviewer Recruitment Form
OMB: 0915-0295
IC ID: 6550
OMB.report
HHS/HSA
OMB 0915-0295
ICR 201612-0915-001
IC 6550
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0295 can be found here:
2023-06-05 - Reinstatement with change of a previously approved collection
2020-02-24 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
DIR Grant Reviewer Recruitment Form
Form and Instruction
1 RRM Screen Shots
RRM Screen Shots 2.pdf
Form and Instruction
Reviewer notice letter.docx
Reviewer notice letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
DIR Grant Reviewer Recruitment Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
RRM Screen Shots
RRM Screen Shots 2.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5,250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
5,250
0
0
0
0
5,250
Annual IC Time Burden (Hours)
1,707
0
0
0
0
1,707
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Reviewer notice letter
Reviewer notice letter.docx
11/06/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.