Information Collection

Phs 2271

IC 217417 under ICR 202003-0925-004 · OMB 0925-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0002 can be found here:

Documents and Forms

Document Name Document Type
Form 10 PHS 2271 Form and Instruction
PHS2271 4-30-19, Amended 1-16-20.docx Instruction
10 Post-Award eRA Commons Screen Shots Attachment 19B - Post-Award eRA Commons Screen Shots_xTrain.docx Form and Instruction
9 PHS 2271 Attachement 12 2271 omb 2019.docx Form
Forms F_General app guide_Ripple_082919 JS_SK_9-23-2019, Amended 1-16-20.docx Application Guide instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PHS 2271	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10	Post-Award eRA Commons Screen Shots	Attachment 19B - Post-Award eRA Commons Screen Shots_xTrain.docx	Yes	Yes	Fillable Fileable
Form	9	PHS 2271	Attachement 12 2271 omb 2019.docx	Yes	Yes	Fillable Fileable
Instruction			PHS2271 4-30-19, Amended 1-16-20.docx	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22,035	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	22,035	22,035
Annual IC Time Burden (Hours)	5,509	5,509
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Application Guide instructions	Forms F_General app guide_Ripple_082919 JS_SK_9-23-2019, Amended 1-16-20.docx	02/05/2020

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