PHS Inclusion Enrollment Report

PHS Research Performance Progress Report and Other Post-award Reporting (OD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0002 can be found here:

Documents and Forms

Document Name Document Type
Form 21 PHS Inclusion Enrollment Report Form and Instruction
21 PHS Inclusion Enrollment Report Attachment 5B PHS Inclusion Enrollment Report Form.docx Form and Instruction

Information Collection (IC) Details

IC Title:	PHS Inclusion Enrollment Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

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	21	PHS Inclusion Enrollment Report	Attachment 5B PHS Inclusion Enrollment Report Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,544	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,544	2,544
Annual IC Time Burden (Hours)	-2,544	2,544
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.