Fellowship Management System

ICR 201705-0920-003

OMB: 0920-0765

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Form and Instruction
Unchanged
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2017-05-03
Justification for No Material/Nonsubstantive Change
2017-03-22
Justification for No Material/Nonsubstantive Change
2015-10-01
Supplementary Document
2014-12-01
Supplementary Document
2014-12-01
Supplementary Document
2014-12-01
Supplementary Document
2014-12-01
Supplementary Document
2014-12-01
Supporting Statement B
2014-12-01
Supporting Statement A
2015-04-03
ICR Details
0920-0765 201705-0920-003
Historical Active 201703-0920-011
HHS/CDC 18896
Fellowship Management System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/05/2017
Retrieve Notice of Action (NOA) 05/04/2017
  Inventory as of this Action Requested Previously Approved
04/30/2018 04/30/2018 04/30/2018
3,931 0 3,781
4,556 0 4,450
0 0 0

The purpose of this change request is for OMB approval of proposed modifications to accommodate changing needs of the fellowship program that reflect evolving fellowship eligibility requirements. Specifically, this change request will support collection of previously identified data elements from an estimated 30 new respondents who are nonfederal applicants to PMR/F in the FMS application module. It will also collect limited new data elements from those 30 applicants, if they elect to participate in a PMR/F program designed for fellows who retain their existing employment in a state, tribal, local, and territorial (STLT) agency and conduct training-in-place.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  79 FR 57557 09/25/2014
79 FR 71103 12/01/2014
Yes

  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 3,931 3,781 0 150 0 0
Annual Time Burden (Hours) 4,556 4,450 0 106 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The purpose of this change request is for OMB approval of proposed modifications to data elements to accommodate the changing needs of the fellowship programs. Specifically, this change request will support collection of previously identified data elements from an estimated 150 new respondents who are nonfederal applicants to the Science Ambassadors Fellowship. This request also proposes to make limited changes to the FMS Application Module to reflect fellowship eligibility requirements, including deletions of selected questions irrelevant to this fellowship to avoid unnecessary burden, and limited revisions to the current questions.

$1,056,000
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Thelma Sims 4046394771

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/04/2017


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