Information Collection

Landis Award for Outstanding Mentorship - Nominations (NINDS)

IC 255259 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⚠️ Notice: This information collection may be referencing outdated material.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 Landis Award for Outstanding Mentorship - Nominations (NINDS)	Form
Form 1 Landis Award for Outstanding Mentorship - Nominations (NINDS)	Form
1 Nominee Information email template request NomineeInformation_TemplateEmailRequest_LandisAward2022-.docx	Form
1 Nominee Information email template request NomineeInformation_TemplateEmailRequest_LandisAward2022-.docx	Form
2 Nomination form screenshot NominationForm_Screenshot2022-.pdf	Form
2 Nomination form screenshot NominationForm_Screenshot2022-.pdf	Form
LandisAward_2022_SubstudyTemplate_0925-0766.docx sub-study for Landis Award Nomination	IC Document
LandisAward_2022_SubstudyTemplate_0925-0766.docx sub-study for Landis Award Nomination	IC Document
Email advertisement text_call for nominations_LandisAward2022-.docx email recruitment	IC Document
Email advertisement text_call for nominations_LandisAward2022-.docx email recruitment	IC Document

IC Title:

Landis Award for Outstanding Mentorship - Nominations (NINDS)

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	1	Nominee Information email template request	NomineeInformation_TemplateEmailRequest_LandisAward2022-.docx		Yes	Yes	Fillable Fileable
Form	2	Nomination form screenshot	NominationForm_Screenshot2022-.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

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	250	250
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub-study for Landis Award Nomination	LandisAward_2022_SubstudyTemplate_0925-0766.docx	08/10/2022
email recruitment	Email advertisement text_call for nominations_LandisAward2022-.docx	08/10/2022

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