Information Collection

Biosketch (424 Electronic)

IC 217561 under ICR 202006-0925-002 · OMB 0925-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:

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

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	Previously Approved
Annual Number of Responses for this IC	80,946	80,946
Annual IC Time Burden (Hours)	161,892	161,892
Annual IC Cost Burden (Dollars)	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.