Information Collection

Nominations for Center for Cancer Training NCI Director's Outstanding Mentor Award (NCI)

IC 263165 under ICR 202307-0925-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Application Nominations for Center for Cancer Training NCI Director's Outstanding Mentor Award (NCI)	Form and Instruction
1 Application OMA Award Application 11.2.23.pdf	Form and Instruction
Email for OMA Call for Noms.docx Email Correspondence	IC Document
Sub-Study Request CCT NCI Director Award 11.2.2023.docx Template	IC Document

IC Title:

Nominations for Center for Cancer Training NCI Director's Outstanding Mentor Award (NCI)

Agency IC Tracking Number:

IC Status: New

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				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD.

FR Citation: 88 FR 49473

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Email Correspondence		11/01/2023
Template		11/02/2023

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

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