Information Collection Request

[PHIC] Fellowship Management System

ICR 202601-0920-003 · OMB 0920-0765 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
FMS Activity Tracking Module draft Form and Instruction Unchanged Available
Form 0920-0765 Reference Letter Form and Instruction Unchanged Available
FMS Application Module Form and Instruction Unchanged Available
Form 0920-0765 FMS Host Site Module_09JAN2026 Form and Instruction Modified Available
Form 0920-0765 FMS Host Site Module Form and Instruction Modified Available
FMS Alumni Tracking Module Draft Form and Instruction Unchanged Repair queued
Form 0920-0765 FMS Application Module_09JAN2026 Form and Instruction Modified Available
Form 0920-0765 FMS Application Module - 11JUL2025 Form and Instruction Modified Available
Form 0920-0765 FMS Application Module Form and Instruction Modified Available
0920-0765 Change Request_Jan 2026_clean.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-01-09 Available
0920-0765 07092025 CR.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-07-11 Available
Change Request EO 14168 14151_2025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-10 Available
Change Request_0920-0765 Dec24.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-12-18 Available
0920-0765 Sept 2024 FMS Change Request.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-09-24 Available
0920-0765 July 2024 FMS Change Request.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-08-05 Available
Change Request Memo OMB No 0920-0765 December 2023.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-01-03 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 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239669 Activity Tracking Form and Instruction UnchangedFMS Activity Tracking Module draft
239668 Reference Letters for Fellowship Applicants Form and Instruction UnchangedReference Letter
232804 FMS Application Writing Samples (Subset Applicants) Form and Instruction UnchangedFMS Application Module
214088 Host Site Module Form and Instruction ModifiedFMS Host Site Module_09JAN2026
214088 Host Site Module Form and Instruction ModifiedFMS Host Site Module
214087 FMS Alumni Directory Form and Instruction UnchangedFMS Alumni Tracking Module Draft
214086 Fellowship Applications Form and Instruction ModifiedFMS Application Module_09JAN2026
214086 Fellowship Applications Form and Instruction ModifiedFMS Application Module - 11JUL2025
214086 Fellowship Applications Form and Instruction ModifiedFMS Application Module

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2026 03/31/2026 03/31/2026
18,212 0 18,212
13,477 0 13,477
1,531,249 0 1,531,249





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
Activity Tracking None
FMS Alumni Directory None
FMS Application Writing Samples (Subset Applicants) None
Fellowship Applications 0920-0765, 0920-0765, 0920-0765 ,   ,  
Host Site Module 0920-0765, 0920-0765, 0920-0765 ,  
Reference Letters for Fellowship Applicants 0920-0765

table that charts list of burden
  Total Approved 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