14 PHS Assignment Request Form

PHS Assigment Request Form

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0MB Number: 0925-001
Expiration Date: 0313112020

Funding Opportunity Number
Funding Opportunity Title

Awarding Component Assignment Suggestions (Optional)

If you have a suggestion for an awarding component (e.g, NIH Institute/Center) assignment, use the link below to identify the appropriate short
abbreviation (e.g. "NCI" for National Cancer Institute) and enter it below in the boxes for "Suggested Awarding Components". All suggestions
will be considered; however, not all assignment suggestions can be honored.
Information about Awarding Components can be found here: https:llgrants.nih.govlgrantslphs_assignment_information.htm#AwardingComponents

Suggested Awarding Components:

Study Section Assignment Suggestions

If you have a suggestion for a study section assignment, use the link below to identify a study section. Enter the short abbreviation for that
study section in the boxes for "Suggested Study Sections". Remove all hyphens, parentheses, and spaces. All suggestions will be considered;
however, not all assignment suggestions can be honored.
For example, enter "CAMP" if you wish to suggest assignment to the NIH Cancer Molecular Pathobiology study section, or "ZRG1 HDMR" if
you wish to suggest assigment to the NIH Healthcare Delivery and Methodologies SBIR/STTR panel for informatics.
Information about study sections can be found here: https:llgrants.nih.govlgrantslphs_assignment_information.htm#StudySection

Suggested Study Sections

Each entry is limited to 20 characters

Rationale for assignment suggestions (optional)
Entry is limited to 1000 characters

List individuals who should not review your application and why (optional)

Entry is limited to 1000 characters

Identify scientific areas of expertise needed to review your application (optional)
Note: Do not provide names of individuals

Expertise:
Each entry is limited to 40 characters