Information Collection

Rachel Pearline Award Nominations (NCI)

IC 249253 under ICR 202301-0925-002 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Rachel Pearline Award Nominations (NCI)	Form and Instruction
Form 1 Rachel Pearline Award Nominations (NCI)	Form and Instruction
1 2022 Rachel Pearline Award nomination 2022 Rachel Pearline Award Nomination Form.pdf	Form and Instruction
1 2022 Rachel Pearline Award nomination 2022 Rachel Pearline Award Nomination Form.pdf	Form and Instruction
Sub-Study Request 10th Annual Global Symp_Pearline FINAL.docx Rachel Pearline Award Nominations (NCI)	IC Document
Sub-Study Request 10th Annual Global Symp_Pearline FINAL.docx Rachel Pearline Award Nominations (NCI)	IC Document
Pearline Award_Call to Nominations Email.docx email invite	IC Document
Pearline Award_Call to Nominations Email.docx email invite	IC Document

IC Title:

Rachel Pearline Award Nominations (NCI)

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

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	2022 Rachel Pearline Award nomination	2022 Rachel Pearline Award Nomination Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Rachel Pearline Award Nominations (NCI)	Sub-Study Request 10th Annual Global Symp_Pearline FINAL.docx	09/09/2021
email invite	Pearline Award_Call to Nominations Email.docx	09/09/2021

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