Information Collection

Renewal Extramural Applicants

IC 237382 under ICR 202602-0925-001 · OMB 0925-0361.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Applicant Renewal Extramural Applicants	Form and Instruction
1 Applicant Applicant 07-27-2022.pdf	Form and Instruction
Eligibilty - HD with burden statement.pdf Eligibility Health Disparities (HD)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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: DHHS 09-25-0165 National Institutes of Health (NIH) Office of Loan Repayment and Scholarship (OLRPS) Record System, HHS/NIH/OD

FR Citation: 67 FR 60742

Number of Respondents: 1,000

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
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-1,000	1,000
Annual IC Time Burden (Hours)	-8,000	8,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Eligibility Health Disparities (HD)		08/15/2019

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

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