[PHIC] Fellowship Management System

ICR 202408-0920-002

OMB: 0920-0765

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0765 can be found here:

2024-09-26 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
Activity Tracking Form and Instruction	Unchanged
Activity Tracking Form and Instruction	Unchanged
Form 0920-0765 Reference Letters for Fellowship Applicants Form and Instruction	Unchanged
Form 0920-0765 Reference Letters for Fellowship Applicants Form and Instruction	Unchanged
FMS Application Writing Samples (Subset Applicants) Form and Instruction	Unchanged
FMS Application Writing Samples (Subset Applicants) Form and Instruction	Unchanged
Form 0920-24HS Host Site Module Form	Modified
Form 0920-24HS Host Site Module Form	Modified
FMS Alumni Directory Form and Instruction	Unchanged
FMS Alumni Directory Form and Instruction	Unchanged
Form 0920-24HS Fellowship Applications Form	Modified
Form 0920-24HS Fellowship Applications Form	Modified
0920-0765 July 2024 FMS Change Request.docx Justification for No Material/Nonsubstantive Change	2024-08-05
0920-0765 July 2024 FMS Change Request.docx Justification for No Material/Nonsubstantive Change	2024-08-05
Change Request Memo OMB No 0920-0765 December 2023.docx Justification for No Material/Nonsubstantive Change	2024-01-03
Change Request Memo OMB No 0920-0765 December 2023.docx Justification for No Material/Nonsubstantive Change	2024-01-03
Change Request Memo 0920-0765_11082023.docx Justification for No Material/Nonsubstantive Change	2023-11-08
Change Request Memo 0920-0765_11082023.docx Justification for No Material/Nonsubstantive Change	2023-11-08
Change Request Memo OMB No 0920-0765 July 2023.docx Justification for No Material/Nonsubstantive Change	2023-08-01
Change Request Memo OMB No 0920-0765 July 2023.docx Justification for No Material/Nonsubstantive Change	2023-08-01
Attachment 8_Privacy Impact Assessment (PIA).pdf Supplementary Document	2022-07-11
Attachment 8_Privacy Impact Assessment (PIA).pdf Supplementary Document	2022-07-11
Attachment 7_IRB Determination Letter FMS 2022.docx Supplementary Document	2022-07-11
Attachment 7_IRB Determination Letter FMS 2022.docx Supplementary Document	2022-07-11
Attachment 2 Published 60-Day FRN.pdf Supplementary Document	2022-07-11
Attachment 2 Published 60-Day FRN.pdf Supplementary Document	2022-07-11
Attachment 1_Authorizing Legislation Public Health Service Act.docx Supplementary Document	2022-07-11
Attachment 1_Authorizing Legislation Public Health Service Act.docx Supplementary Document	2022-07-11
SUPPORTING STATEMENT B Revision #0920-0765.docx Supporting Statement B	2022-07-11
SUPPORTING STATEMENT B Revision #0920-0765.docx Supporting Statement B	2022-07-11
SUPPORTING STATEMENT A Revision_06242022.docx Supporting Statement A	2022-07-11
SUPPORTING STATEMENT A Revision_06242022.docx Supporting Statement A	2022-07-11

IC Document Collections

IC ID	Document Title	Status
239669	Activity Tracking Form and Instruction	Unchanged
239669	Activity Tracking Form and Instruction	Unchanged
239668	Reference Letters for Fellowship Applicants Form and Instruction	Unchanged
239668	Reference Letters for Fellowship Applicants Form and Instruction	Unchanged
232804	FMS Application Writing Samples (Subset Applicants) Form and Instruction	Unchanged
232804	FMS Application Writing Samples (Subset Applicants) Form and Instruction	Unchanged
214088	Host Site Module Form	Modified
214088	Host Site Module Form	Modified
214087	FMS Alumni Directory Form and Instruction	Unchanged
214087	FMS Alumni Directory Form and Instruction	Unchanged
214086	Fellowship Applications Form	Modified
214086	Fellowship Applications Form	Modified

ICR Details