Information Collection Request

Fellowship Management System

ICR 202201-0920-004 · OMB 0920-0765 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0765 Activity Tracking Form and Instruction Modified Repair queued
Form 0920-0765 Reference Letters for Fellowship Applicants Form and Instruction Unchanged Repair queued
Form 0920-0765 FMS Application Writing Samples (Subset Applicants) Form and Instruction Unchanged Available
FMS Host Site Module Form and Instruction Modified Repair queued
FMS Alumni Directory Form and Instruction Unchanged Repair queued
Fellowship Applications Form and Instruction Modified Repair queued
eFMS 2.0 Change Request for EWB_Dec 2021_final.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-01-10 Repair queued
eFMS Change Request 0920-0765 - Nov 2021.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-11-16 Missing upstream
eFMS Change Request 0920-0765-Nov 2021 Attachment C Host Site Module Screenshots.docx Supplementary Document Uploaded 2021-11-16 Missing upstream
eFMS Change Request 0920-0765-Nov 2021 Attachment B Application Module Screenshots.docx Supplementary Document Uploaded 2021-11-16 Repair queued
Attachment D_Screenshots for Host Site Module-June 2021.docx Supplementary Document Uploaded 2021-06-08 Available
Attachment C_ Screenshots for Application Module-June 2021.docx Supplementary Document Uploaded 2021-06-08 Repair queued
OMB Change Request - 0920-0765 - June 2021 R1.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-06-08 Repair queued
OMB Change Request - 0920-0765 - Spring 2021_passback 2.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-03-16 Repair queued
SSB_01312020.docx Supporting Statement B Uploaded 2020-01-31 Repair queued
0920-0765 Supporting Statement A_revised 3-31-2020.docx Supporting Statement A Uploaded 2020-03-31 Repair queued
Attachment_8_PIA.pdf Supplementary Document Uploaded 2020-01-28 Repair queued
Attachment_7_Research_Determination_Memo_FMS.pdf Supplementary Document Uploaded 2020-01-28 Repair queued
Attachment_2_60 Day FRN.pdf Supplementary Document Uploaded 2020-01-28 Repair queued
Attachment 1_Public Health Service Act.docx Supplementary Document Uploaded 2020-01-28 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239669 Activity Tracking Form and Instruction Modified
239668 Reference Letters for Fellowship Applicants Form and Instruction Unchanged
232804 FMS Application Writing Samples (Subset Applicants) Form and Instruction Unchanged
214088 FMS Host Site Module Form and Instruction Modified
214087 FMS Alumni Directory Form and Instruction Unchanged
214086 Fellowship Applications Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
03/31/2023 03/31/2023
9,708 9,708
5,983 5,773
586,324 586,324





table that charts list 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) 5,983 5,773 0 210 0 0
Annual Cost Burden (Dollars) 586,324 586,324 0 0 0 0


Reginfo record details
  No