PHS 398 Career Development Award Supplemental Form

PHS Applications and Pre-award Related Reporting (OD)

⚠️ Notice: This information collection may be referencing outdated material.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 11 PHS 398 Career Development Award Supplemental Form Form
11 PHS 398 Career Development Award Supplemental Form Attachment 5Q_PHS398_CareerDevelopmentAwardSup_5_0-V5.0_FORMS-G.pdf Form
11 PHS 398 Career Development Award Supplemental Form Attachment 5Q_PHS398_CareerDevelopmentAwardSup_5_0-V5.0_FORMS-G.pdf Form
Attachment 5P_PHS 398 Career Development Supplemental Form_Instructions_FORMS-G.pdf PHS Career Development Award Supplemental Instructions IC Document
Attachment 5P_PHS 398 Career Development Supplemental Form_Instructions_FORMS-G.pdf PHS Career Development Award Supplemental Instructions IC Document

Information Collection (IC) Details

IC Title:	PHS 398 Career Development Award Supplemental Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	11	PHS 398 Career Development Award Supplemental Form	Attachment 5Q_PHS398_CareerDevelopmentAwardSup_5_0-V5.0_FORMS-G.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,251	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,251	2,251
Annual IC Time Burden (Hours)	22,510	22,510
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PHS Career Development Award Supplemental Instructions	Attachment 5P_PHS 398 Career Development Supplemental Form_Instructions_FORMS-G.pdf	08/09/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.