Fellowship Management System

Forms and Documents

Document Name	Status
Form 0920-0675 Activity Tracking Form and Instruction	Modified
Form 0920-0765 Reference Letters for Fellowship Applicants Form and Instruction	Modified
Form 0920-0765 FMS Application Writing Samples (Subset Applicants) Form and Instruction	Modified
Form 0920-0765 FMS Host Site Module Form and Instruction	Modified
Form 0920-0765 FMS Alumni Directory Form and Instruction	Modified
Form 0920-0675 Fellowship Applications Form and Instruction	Modified
OMB Change Request - 0920-0765 - Spring 2021_2.18.docx Justification for No Material/Nonsubstantive Change	2021-03-01
SSB_01312020.docx Supporting Statement B	2020-01-31
0920-0765 Supporting Statement A_revised 3-31-2020.docx Supporting Statement A	2020-03-31
Attachment_8_PIA.pdf Supplementary Document	2020-01-28
Attachment_7_Research_Determination_Memo_FMS.pdf Supplementary Document	2020-01-28
Attachment_2_60 Day FRN.pdf Supplementary Document	2020-01-28
Attachment 1_Public Health Service Act.docx Supplementary Document	2020-01-28

IC Document Collections

IC ID	Document Title	Status
239669	Activity Tracking Form and Instruction	Modified
239668	Reference Letters for Fellowship Applicants Form and Instruction	Modified
232804	FMS Application Writing Samples (Subset Applicants) Form and Instruction	Modified
214088	FMS Host Site Module Form and Instruction	Modified
214087	FMS Alumni Directory Form and Instruction	Modified
214086	Fellowship Applications Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0765	ICR Reference No: 202102-0920-014
Status: Received in OIRA	Previous ICR Reference No: 201911-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0765
Title: Fellowship Management System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/01/2021

	Requested	Previously Approved
Expiration Date	03/31/2023	03/31/2023
Responses	9,708	9,708
Time Burden (Hours)	4,881	4,881
Cost Burden (Dollars)	550,826	550,826

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Abstract: This is a request for revision of the Fellowship Management System (FMS) information collection to continue to collect data under the approved OMB No. 0920-0765. CDC uses FMS to collect, process, and manage data from non-federal applicants seeking training or public health support services through CDC fellowships. FMS is used to electronically submit fellowship applications and fellowship host site proposals, and to maintain fellowship alumni directories on-line.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 44313	08/23/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 5664	01/31/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
FMS Application Writing Samples (Subset Applicants)	0920-0765	FMS 2.0 Application Module - 13.6
Fellowship Applications	0920-0675	Attachment 3_FMS 2.0 Application Module
FMS Host Site Module	0920-0765	FMS 2.0 Host Site Module
FMS Alumni Directory	0920-0765	FMS 2.0 Alumni Tracking Module
Reference Letters for Fellowship Applicants	0920-0765	FMS Application Module (12.2 – 12.3.3)
Activity Tracking	0920-0675	FMS 2.0 Activity Tracking Module

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ICR Summary of Burden

	Total Request	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	9,708	9,708	0	0	0	0
Annual Time Burden (Hours)	4,881	4,881	0	0	0	0
Annual Cost Burden (Dollars)	550,826	550,826	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $465,133

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/01/2021

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