Information Collection

PHS Fellowship Supplemental Form (includes F reference letters)

IC 217563 under ICR 202408-0925-001 · OMB 0925-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 PHS Fellowship Supplemental Form (includes F reference letters)	Form
Attachment 15_eRA Commons Profile Data Elements.xlsx	Other-Data Elements
Attachment 15_eRA Commons Profile Data Elements.xlsx	Other-Data Elements
1 Form Attachment 6A_PHS Fellowship Supplemental Form_Instructions_FORMS-I.docx	Form
1 Form Attachment 6A_PHS Fellowship Supplemental Form_Instructions_FORMS-I.docx	Form
2 Form Attachment 6B_PHS_Fellowship_Supplemental_8_0-V8.0_FORMS-I (2).pdf	Form
2 Form Attachment 6B_PHS_Fellowship_Supplemental_8_0-V8.0_FORMS-I (2).pdf	Form

IC Title:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Form	Attachment 6A_PHS Fellowship Supplemental Form_Instructions_FORMS-I.docx	Yes	Yes	Fillable Fileable
Form	2	Form	Attachment 6B_PHS_Fellowship_Supplemental_8_0-V8.0_FORMS-I (2).pdf	Yes	Yes	Fillable Fileable
Other-Data Elements			Attachment 15_eRA Commons Profile Data Elements.xlsx	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,707

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	6,707	6,707
Annual IC Time Burden (Hours)	87,191	87,191
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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