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Biosketch (424 Electronic)
PHS Applications and Pre-award Related Reporting (OD)
OMB: 0925-0001
IC ID: 217561
OMB.report
HHS/NIH
OMB 0925-0001
ICR 201708-0925-002
IC 217561
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:
2022-10-05 - Revision of a currently approved collection
2022-07-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 12
Biosketch (424 Electronic)
Form
12 General Biographical Sketch Format Page
Attachment 9A General Biographical Sketch Format Page.docx
Form
Attachment 9B General and Fellowship Biographical Sketch Instructions.docx
Attachment 9B General and Fellowship Biographical Sketch Instructions
IC Document
Attachment 9C General Biographical Sketch Sample.docx
Attachment 9C General Biographical Sketch Sample
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Biosketch (424 Electronic)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
12
General Biographical Sketch Format Page
Attachment 9A General Biographical Sketch Format Page.docx
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:
80,946
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
80,946
0
0
0
0
80,946
Annual IC Time Burden (Hours)
161,892
0
0
0
0
161,892
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 9B General and Fellowship Biographical Sketch Instructions
Attachment 9B General and Fellowship Biographical Sketch Instructions.docx
01/25/2017
Attachment 9C General Biographical Sketch Sample
Attachment 9C General Biographical Sketch Sample.docx
01/25/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.