View Information Collection (IC)

View Information Collection (IC)

IC Title:	Biosketch (424 Electronic)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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 Biographical Sketch Format Page	Attachment 9A General Biographical Sketch Format Page.docx		Yes	Yes	Fillable Fileable

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: 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 %

	Requested	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	80,946	0	0	0	0	80,946
Annual IC Time Burden (Hours)	161,892	0	0	0	0	161,892
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 9B General and Fellowship Biographical Sketch Instructions	Attachment 9B General and Fellowship Biographical Sketch Instructions.docx	01/25/2017
Attachment 9C General Biographical Sketch Sample	Attachment 9C General Biographical Sketch Sample.docx	01/25/2017

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