Information Collection

Phs 416-7

IC 225309 under ICR 202408-0925-003 · OMB 0925-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 PHS 416-7	Form and Instruction
1 Form Attachment 13_phs416-7 form and instructions.docx	Form and Instruction
1 Form Attachment 13_phs416-7 form and instructions.docx	Form and Instruction
2 Form Attachment 19 - Post-Award eRA Commons Screen Shots_xTrain_07-2024.docx	Form
2 Form Attachment 19 - Post-Award eRA Commons Screen Shots_xTrain_07-2024.docx	Form

IC Title:

PHS 416-7

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Form	Attachment 13_phs416-7 form and instructions.docx		Yes	Yes	Fillable Fileable
Form	2	Form	Attachment 19 - Post-Award eRA Commons Screen Shots_xTrain_07-2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12,580

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	12,580	12,580
Annual IC Time Burden (Hours)	6,290	6,290
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.