Information Collection Request

[PHIC] Fellowship Management System

ICR 202311-0920-007 · OMB 0920-0765 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Activity Tracking Form and Instruction Unchanged Available
Form 0920-0765 Reference Letters for Fellowship Applicants Form and Instruction Modified Repair queued
FMS Application Writing Samples (Subset Applicants) Form and Instruction Unchanged Repair queued
Form 0920-0765 Host Site Module Form and Instruction Modified Available
FMS Alumni Directory Form and Instruction Unchanged Repair queued
Form 0920-0765 Fellowship Applications Form and Instruction Modified Available
Change Request Memo 0920-0765_11082023.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-11-08 Available
Change Request Memo OMB No 0920-0765 July 2023.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-08-01 Available
Attachment 8_Privacy Impact Assessment (PIA).pdf Supplementary Document Uploaded 2022-07-11 Available
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 Available
Attachment 1_Authorizing Legislation Public Health Service Act.docx Supplementary Document Uploaded 2022-07-11 Available
SUPPORTING STATEMENT B Revision #0920-0765.docx Supporting Statement B Uploaded 2022-07-11 Available
SUPPORTING STATEMENT A Revision_06242022.docx Supporting Statement A Uploaded 2022-07-11 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239669 Activity Tracking Form and Instruction Unchanged
239668 Reference Letters for Fellowship Applicants Form and Instruction Modified
232804 FMS Application Writing Samples (Subset Applicants) Form and Instruction Unchanged
214088 Host Site Module Form and Instruction Modified
214087 FMS Alumni Directory Form and Instruction Unchanged
214086 Fellowship Applications Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
03/31/2026 03/31/2026
18,212 18,212
13,477 13,477
1,531,249 1,531,249





table that charts list of burden
  Total Request 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 18,212 18,212 0 0 0 0
Annual Time Burden (Hours) 13,477 13,477 0 0 0 0
Annual Cost Burden (Dollars) 1,531,249 1,531,249 0 0 0 0


Reginfo record details
  No