| Statement of Appointment |
PHS 2271 |
Use for each appointment of an individual as a trainee under a Kirschstein-NRSA or other institutional training grant.
Also use for appointments on career development awards. |
Statement of Appointment form and instructions (PDF, MS Word)
|
|
The use of the eRA Commons xTrain system is mandatory to electronically prepare and submit PHS 2271 Statement of Appointment forms.
Log onto the eRA Commons to access xTrain. |
February 2016 |
| Individual Fellowship Activation Notice (PHS 416-5) |
PHS 416-5 (PDF - 39 KB) |
All fellows must complete this form for the first year of their fellowship, indicating their start date under the fellowship and other requested information. |
Individual Fellowship form and instructions (PDF, MS Word)
|
|
There is no electronic submission system for fellowship activation notices. |
June 2017 |
| Termination Notice |
PHS 416-7 |
Used to document the termination of appointments to non-NRSA individual and institutional research training programs. The Termination Notice serves as the official record of your training. |
Termination Notice form and instruction (PDF, MS Word)
|
|
The use of the eRA Commons xTrain system is mandatory to electronically prepare Termination Notices.
Log onto the eRA Commons to access xTrain. |
August 2017 |
| Payback Agreement |
PHS 6031 |
To be completed by trainees and fellows in their first 12 months of post-doctoral support. |
Payback Agreement instructions and form (PDF, MS Word) |
|
There is no electronic system for submission of the Payback Agreement. |
August 2017 |
| Annual Payback Activities Certification (APAC) |
PHS 6031-1 |
The Annual Payback Activities Certification form is the formal communication between former Kirschstein-NRSA recipients and the PHS regarding the status of payback activities. The certification form must be signed and returned to the NRSA Payback Service center. See form instruction for details. |
Annual Payback Activities Certification instruction and form (PDF, MS Word) |
|
There is no electronic system for submission of the Annual Payback Activities Certification. |
August 2017 |
