Biosketch (424 Electronic)

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⚠️ Notice: This information collection may be referencing outdated material.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 12 Biosketch (424 Electronic) Form
12 General Non-Fellowship Biographical Sketch Format Page Attachment 9A_Att A2_General Non-Fellowship Biographical Sketch Format Page_6-28-2021.docx Form
12 General Non-Fellowship Biographical Sketch Format Page Attachment 9A_Att A2_General Non-Fellowship Biographical Sketch Format Page_6-28-2021.docx Form
Attachment 9B_Att B_General and Fellowship Biographical Sketch Instructions_6-28-2021.docx Attachment 9B General and Fellowship Biographical Sketch Instructions IC Document
Attachment 9B_Att B_General and Fellowship Biographical Sketch Instructions_6-28-2021.docx Attachment 9B General and Fellowship Biographical Sketch Instructions IC Document

Information Collection (IC) Details

IC Title:	Biosketch (424 Electronic)	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	12	General Non-Fellowship Biographical Sketch Format Page	Attachment 9A_Att A2_General Non-Fellowship Biographical Sketch Format Page_6-28-2021.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80,946	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	80,946	80,946
Annual IC Time Burden (Hours)	161,892	161,892
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 9B General and Fellowship Biographical Sketch Instructions	Attachment 9B_Att B_General and Fellowship Biographical Sketch Instructions_6-28-2021.docx	08/10/2021

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