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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
398 Forms and Instructions (Paper)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
3A
Paper Application Form
Attachment 3A PHS 398 Paper Application Forms.doc
Yes
Yes
Paper Only
Form
3B
NRSA Data Table Format
Attachment 3B PHS 398 NRSA Data Table Format.docx
Yes
Yes
Paper Only
Instruction
Attachment 4B PHS 398 NRSA Data Table Format Instructions.docx
Yes
Yes
Paper Only
Instruction
Attachment 4A PHS 398 Paper Application Instructions.doc
Yes
Yes
Paper Only
Instruction
Attachment 11 Supplemental Instructions for PHS 398 and PHS 416 Applications.doc
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
8,389
Number of Respondents for Small Entity:
0
Affected Public:
Federal Government
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
8,389
0
0
0
0
8,389
Annual IC Time Burden (Hours)
293,615
0
0
0
0
293,615
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.