Information Collection Request

PHS Applications and Pre-award Related Reporting (OD)

ICR 202210-0925-002 · OMB 0925-0001 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 1 PHS 398 Paper Form Unchanged Repair queued
Form 1 NIH Other Transaction Application Form Form and Instruction New Repair queued
Form 1 Data Management Sharing Plan Form and Instruction New Missing upstream
Form 16 398/424 PHS Human Subjects and Clinical Trial Information (includes inclusion enrollment report) Form and Instruction Unchanged Repair queued
Form 29 PHS 416-5 Form and Instruction Unchanged Available
Form 1 SBIR/STTR Funding Agreement Certification Form and Instruction Modified Repair queued
Form 26 VCOC Certification Form and Instruction Unchanged Repair queued
Form 1 PHS 6031 Form and Instruction Unchanged Repair queued
Form 19 416-1 Form and Instruction Unchanged Repair queued
Form 1 Biosketch (Fellowship) Form and Instruction Modified Repair queued
Form 15 PHS Fellowship Supplemental Form (includes F reference letters) Form and Instruction Modified Repair queued
Form 12 Biosketch (424 Electronic) Form Unchanged Missing upstream
Form 1 PHS 398 Career Development Award Supplemental Form Form and Instruction Modified Repair queued
Form 10 Data Tables Form and Instruction Unchanged Missing upstream
Form 1 PHS 398 Research Training Program Plan Form and Instruction Modified Repair queued
Form 1 PHS 398 Research Plan Form and Instruction Modified Missing upstream
Form 7 PHS 398 Training Subaward Budget Attachment(s) Form Form Unchanged Repair queued
Form 6 PHS 398 Training Budget Form Unchanged Repair queued
Form 5 PHS 398 Modular Budget Form and Instruction Modified Repair queued
Form 4 PHS 398 Cover Page Supplement Form Unchanged Repair queued
Form 3 PHS Assignment Request Form Form Unchanged Repair queued
Supporting Statement A for 0925-0001_FORMS-H (1) (2) (1) (1).docx Supporting Statement A Uploaded 2022-10-05 Repair queued
NIH Other Support and In-Kind_Instructions_07-2022_clean.docx Supplementary Document Uploaded 2022-10-05 Repair queued
Other Support Format Page_07-2022_clean.docx Supplementary Document Uploaded 2022-10-05 Repair queued
0001 30 day notice.pdf Supplementary Document Uploaded 2022-10-05 Repair queued
Fellowship Biographical Sketch Format Page_07-2022_mark-up.docx Supplementary Document Uploaded 2022-07-21 Repair queued
General Non-Fellowship Biographical Sketch Format Page_07-2022_mark-up.docx Supplementary Document Uploaded 2022-07-21 Repair queued
NIH Other Support Format Page_07-2022_mark-up.docx Supplementary Document Uploaded 2022-07-21 Repair queued
SBIR-Funding-Agreement-Certification_5-2022_mark-up.docx Supplementary Document Uploaded 2022-07-21 Available
STTR-Funding-Agreement-Certification_5-2022_mark-up.docx Supplementary Document Uploaded 2022-07-21 Repair queued
0001 OMB Change Request Memo_July 2022v2.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-07-21 Repair queued
pub 30day 0001 2021-17031.pdf Supplementary Document Uploaded 2021-08-10 Repair queued
Att D NIH Other Support and In-Kind_Instructions_6-28-2021.docx Supplementary Document Uploaded 2021-08-10 Repair queued
Att C NIH Other Support Format Page_6-28-2021.docx Supplementary Document Uploaded 2021-08-10 Repair queued
Attachment 19 HHS Approved PIA - Electronic Research Administration 7152019.docx Supplementary Document Uploaded 2019-12-27 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
37814 PHS 398 Paper Form Unchanged
256274 NIH Other Transaction Application Form Form and Instruction New
256273 Data Management Sharing Plan Form and Instruction New
225108 398/424 PHS Human Subjects and Clinical Trial Information (includes inclusion enrollment report) Form and Instruction Unchanged
217591 PHS 416-5 Form and Instruction Unchanged
217570 SBIR/STTR Funding Agreement Certification Form and Instruction Modified
217569 VCOC Certification Form and Instruction Unchanged
217568 PHS 6031 Form and Instruction Unchanged
217567 416-1 Form and Instruction Unchanged
217566 Biosketch (Fellowship) Form and Instruction Modified
217563 PHS Fellowship Supplemental Form (includes F reference letters) Form and Instruction Modified
217561 Biosketch (424 Electronic) Form Unchanged
217560 PHS 398 Career Development Award Supplemental Form Form and Instruction Modified
217559 Data Tables Form and Instruction Unchanged
217558 PHS 398 Research Training Program Plan Form and Instruction Modified
217557 PHS 398 Research Plan Form and Instruction Modified
217556 PHS 398 Training Subaward Budget Attachment(s) Form Form Unchanged
217555 PHS 398 Training Budget Form Unchanged
202980 PHS 398 Modular Budget Form and Instruction Modified
202963 PHS 398 Cover Page Supplement Form Unchanged
202959 PHS Assignment Request Form Form Unchanged
ICR Details
0925-0001 202210-0925-002
Received in OIRA 202207-0925-002
HHS/NIH 19797
PHS Applications and Pre-award Related Reporting (OD)
Revision of a currently approved collection   No
Regular 10/05/2022
  Requested Previously Approved
36 Months From Approved 09/30/2024
486,749 413,393
2,175,670 2,023,454
0 0

The National Institutes of Health (NIH) and other Public Health Service (PHS) agencies currently use the Research and Research Training Grant Applications and Related Forms and Ruth L. Kirschstein National Research Service Award (NRSA) Applications and Related Forms (0925-0001 Expiration Date: February 28, 2023). This collection is being revised to convert the Inclusion Enrollment Report form to a Common form to include the Department of Defense (DoD) and any other agencies who wishes to use this form in the future. The forms original use will remain the same from previous submissions however, it will take on a new OMB# and expiration date from the other forms associated with this submission. The Inclusion Enrollment Report is used for all applications involving NIH-defined clinical research. This form is used to report both planned and cumulative (or actual) enrollment, and describes the sex/gender, race, and ethnicity of the study participants. In addition to converting the Inclusion Enrollment Report to a common form, other revisions include NIH requiring applicants and recipients to provide their Unique Entity Identifier (UEI) instead of the Data Universal Number System (DUNS) number starting in January 2022. Also, the application forms will be updated to align with the Grants.gov updated Country and State lists.

US Code: 42 USC 300 Name of Law: Public Health Service Act
   US Code: 42 USC 286 Name of Law: Public Health Service Act
   US Code: 42 USC 216 Name of Law: Public health Service Act
   US Code: 42 USC 285 Name of Law: public Health Serice Act
   US Code: 42 USC 241 Name of Law: Public Health Service
   US Code: 42 USC 288 Name of Law: Public Health Serive Act
  
None

Not associated with rulemaking

  87 FR 34891 06/08/2022
87 FR 60180 10/04/2022
No

21
IC Title Form No. Form Name
398/424 PHS Human Subjects and Clinical Trial Information (includes inclusion enrollment report) 16, 18, 17 Landing Page ,   Inclusion Enrollment Report ,   HSCT Sections 1-6
416-1 19, 20, 21, 22, 24, 23 Attachment 7B PHS 416-1 Face Page 1 ,   Attachment 7C PHS 416-1 Face Page 2 ,   Attachment 7D PHS 416-1 Face Page 3 ,   Attachment 7E PHS 416-1 Face Page 4 ,   Attachment 7F PHS 416-1 Checklist Form Page ,   Attachment 7G PHS 416-1 Continuation Page
Biosketch (424 Electronic) 12 General Non-Fellowship Biographical Sketch Format Page
Biosketch (Fellowship) 1 General Non-Fellowship Biographical Sketch Format Page
Data Management Sharing Plan 1 DMS Plan Format Page
Data Tables 10 Introduction to the Data Tables
NIH Other Transaction Application Form 1 Other Transaction Application Form Screenshots
PHS 398 Career Development Award Supplemental Form 1 PHS 398 Career Development Form Instructions
PHS 398 Cover Page Supplement 4 PHS 398 Cover Page Supplement Forms
PHS 398 Modular Budget 5 PHS 398 Modular Budget Form
PHS 398 Paper 1, 2 PHS 398 Paper Application Forms ,   PHS 398 Paper Application Instructions
PHS 398 Research Plan 1 PHS 398 Research Plan Form
PHS 398 Research Training Program Plan 1 PHS 398 Research Training Program Plan
PHS 398 Training Budget 6 PHS 398 Training Budget Form
PHS 398 Training Subaward Budget Attachment(s) Form 7 Attachment 5M PHS 398 Training Subaward Budget Form
PHS 416-5 29 PHS 416.5
PHS 6031 1 PHS 6031
PHS Assignment Request Form 3 PHS Assignment Reqest Form
PHS Fellowship Supplemental Form (includes F reference letters) 15, 1 eRA Commons Profile Data Elements ,   PHS Fellowship Supplemental Form
SBIR/STTR Funding Agreement Certification 1, 2 SBIR Funding Agreement Certification ,   STTR Funding Agreement Certification
VCOC Certification 26 VCOC Certification

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 486,749 413,393 0 73,356 0 0
Annual Time Burden (Hours) 2,175,670 2,023,454 0 152,216 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This submission represents a program change due to the implementation of the NIH Data Management and Sharing Policy and the introduction of the new optional Data Management and Sharing Plan format page. Burden hours of 146,234 were added to the new Data Management and Sharing Plan line item. The application form for the NIH Other Transactions was also added to this collection; 2,629 burden hours were added to the NIH Other Transaction Application Form line item. The PHS Fellowship Supplemental Form (includes F reference letters) estimated time went from 12.5 hours to 13 hours. The burden estimate has now been adjusted to a difference of 152,216.

$238,382
No
    Yes
    Yes
No
No
No
No
Mikia Currie 3014350941

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/05/2022