Information Collection

PHS 398 Career Development Award Supplemental Form

IC 217560 under ICR 202210-0925-002 · OMB 0925-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 PHS 398 Career Development Award Supplemental Form	Form and Instruction
1 PHS 398 Career Development Form Instructions Attachment 5P_PHS 398 Career_Dev_Supp_Form_Instructions_FORMS-H.docx	Form and Instruction
1 PHS 398 Career Development Form Instructions Attachment 5P_PHS 398 Career_Dev_Supp_Form_Instructions_FORMS-H.docx	Form and Instruction
Attachment 5P_PHS 398 Career_Dev_Supp_Form_Instructions_FORMS-H.docx PHS Career Development Award Supplemental Instructions	IC Document
Attachment 5P_PHS 398 Career_Dev_Supp_Form_Instructions_FORMS-H.docx PHS Career Development Award Supplemental Instructions	IC Document

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	PHS 398 Career Development Form Instructions	Attachment 5P_PHS 398 Career_Dev_Supp_Form_Instructions_FORMS-H.docx		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: 100 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
PHS Career Development Award Supplemental Instructions	Attachment 5P_PHS 398 Career_Dev_Supp_Form_Instructions_FORMS-H.docx	10/05/2022

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