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.

There is no electronic system for submission of the Annual Payback Activities Certification. 

NIH Grants Policy Statement, Section 11.4.4 Certification of Payback Activities

Annual Payback Activities Certification instruction and form
Annual Payback Activities Certification instruction and form

July 2023