PHS 398 Career Development Award Supplemental Form

PHS Applications and Pre-award Related Reporting (OD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0001 can be found here:

Documents and Forms

Document Name Document Type
Form 11 PHS 398 Career Development Award Supplemental Form Form
11 PHS 398 Career Development Award Supplemental Form Attachment 5Q PHS 398 Career Development Award Supplemental Form_FORMS-F.pdf Form
Attachment 5P_PHS 398 Career Developmental Award Supplemental Form_Instructions_FORMS-F.pdf PHS Career Development Award Supplemental Instructions IC Document

Information Collection (IC) Details

IC Title:	PHS 398 Career Development Award Supplemental Form	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	11	PHS 398 Career Development Award Supplemental Form	Attachment 5Q PHS 398 Career Development Award Supplemental Form_FORMS-F.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,251	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,251	2,251
Annual IC Time Burden (Hours)	22,510	22,510
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PHS Career Development Award Supplemental Instructions	Attachment 5P_PHS 398 Career Developmental Award Supplemental Form_Instructions_FORMS-F.pdf	12/27/2019

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