Information Collection

PMR/F Fellowship Applicants

IC 226159 under ICR 201705-0920-003 · OMB 0920-0765.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0765 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0765 PMR/F Fellowship Applicants	Form
0920-0765 Attachment_2-Original FMS_Application_Module Attachment_2-Original FMS_Application_Module.docx	Form
0920-0765 FMS Science Ambassadors Attachment_2-Original FMS_Application_Module.docx	Form

IC Title:

PMR/F Fellowship Applicants

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0765	Attachment_2-Original FMS_Application_Module	Attachment_2-Original FMS_Application_Module.docx		Yes	Yes	Fillable Fileable
Form	0920-0765	FMS Science Ambassadors	Attachment_2-Original FMS_Application_Module.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	150	120	30
Annual IC Time Burden (Hours)	113	53	60
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.