Information Collection Request

Fellowship Management System

ICR 202206-0920-010 · OMB 0920-0765 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
FMS Activity Tracking Module draft Form and Instruction Modified Available
Activity Tracking Form and Instruction Modified Repair queued
FMS Application Module draft (sections 12.1-12.3, pages 101-111) Form and Instruction Modified Repair queued
Reference Letters for Fellowship Applicants Form and Instruction Modified Repair queued
FMS Application Module draft (section 13.6.1, pages 132-133) Form and Instruction Modified Available
FMS Application Writing Samples (Subset Applicants) Form and Instruction Modified Repair queued
FMS Host Site Module draft Form and Instruction Modified Available
FMS Host Site Module Form and Instruction Modified Repair queued
FMS Alumni Tracking Module Draft Form and Instruction Modified Available
FMS Alumni Directory Form and Instruction Modified Repair queued
FMS Application Module draft Form and Instruction Modified Repair queued
Fellowship Applications Form and Instruction Modified Repair queued
Attachment 8_Privacy Impact Assessment (PIA).pdf Supplementary Document Uploaded 2022-07-11 Repair queued
Attachment 7_IRB Determination Letter FMS 2022.docx Supplementary Document Uploaded 2022-07-11 Repair queued
Attachment 2 Published 60-Day FRN.pdf Supplementary Document Uploaded 2022-07-11 Repair queued
Attachment 1_Authorizing Legislation Public Health Service Act.docx Supplementary Document Uploaded 2022-07-11 Repair queued
SUPPORTING STATEMENT B Revision #0920-0765.docx Supporting Statement B Uploaded 2022-07-11 Repair queued
SUPPORTING STATEMENT A Revision_06242022.docx Supporting Statement A Uploaded 2022-07-11 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239669 Activity Tracking Form and Instruction ModifiedFMS Activity Tracking Module draft
239669 Activity Tracking Form and Instruction Modified
239668 Reference Letters for Fellowship Applicants Form and Instruction ModifiedFMS Application Module draft (sections 12.1-12.3, pages 101-111)
239668 Reference Letters for Fellowship Applicants Form and Instruction Modified
232804 FMS Application Writing Samples (Subset Applicants) Form and Instruction ModifiedFMS Application Module draft (section 13.6.1, pages 132-133)
232804 FMS Application Writing Samples (Subset Applicants) Form and Instruction Modified
214088 FMS Host Site Module Form and Instruction ModifiedFMS Host Site Module draft
214088 FMS Host Site Module Form and Instruction Modified
214087 FMS Alumni Directory Form and Instruction ModifiedFMS Alumni Tracking Module Draft
214087 FMS Alumni Directory Form and Instruction Modified
214086 Fellowship Applications Form and Instruction ModifiedFMS Application Module draft
214086 Fellowship Applications Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2026 36 Months From Approved 03/31/2023
17,762 0 9,708
13,186 0 6,484
1,499,849 0 586,324





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
Activity Tracking None
FMS Alumni Directory None
FMS Application Writing Samples (Subset Applicants) None
FMS Host Site Module None
Fellowship Applications None
Reference Letters for Fellowship Applicants None

table that charts list of burden
  Total Approved 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 17,762 9,708 0 8,054 0 0
Annual Time Burden (Hours) 13,186 6,484 0 6,702 0 0
Annual Cost Burden (Dollars) 1,499,849 586,324 0 913,525 0 0


Reginfo record details
  No