398 Forms and Instructions (Paper)

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⚠️ Notice: This information collection may be referencing outdated material.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 3A 398 Forms and Instructions (Paper) Form
Attachment 4B PHS 398 NRSA Data Table Format Instructions.docx Instruction
Attachment 4A PHS 398 Paper Application Instructions.doc Instruction
Attachment 11 Supplemental Instructions for PHS 398 and PHS 416 Applications.doc Instruction
3A Paper Application Form Attachment 3A PHS 398 Paper Application Forms.doc Form
3B NRSA Data Table Format Attachment 3B PHS 398 NRSA Data Table Format.docx Form

Information Collection (IC) Details

IC Title:	398 Forms and Instructions (Paper)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	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

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	Previously Approved
Annual Number of Responses for this IC	8,389	8,389
Annual IC Time Burden (Hours)	293,615	293,615
Annual IC Cost Burden (Dollars)	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.