Revised PHS 2271, PHS 3734, and HHS 568 Forms Now Available

Notice Number: NOT-OD-08-029

Key Dates
Release Date: January 4, 2008

Issued by
National Institutes of Health (NIH), (

NIH announces the availability of three revised (11/2007) forms:
1) PHS 2271 (Statement of Appointment);
2) PHS 3734 (Official Statement Relinquishing Interest and Rights in a PHS Research Grant);
3) HHS 568 (Final Invention Statement and Certification).

The newly revised forms and instructions are available at . The forms continue to be provided in two electronic formats MS Word and PDF-fillable using Adobe Acrobat Reader Software. Free Adobe Software may be accessed at .

PHS 2271 (Statement of Appointment)

A number of changes have been incorporated into this form. Notable changes include:

  • Implementation of a previously approved use of the form for individuals appointed to institutional career development awards (scholars).
  • Modifications to the form to allow for its use in conjunction with non-NRSA research training grants and research education awards.
  • Integration of the NIH diversity recruitment and retention policy described in institutional Kirschstein-NRSA training grant, institutional career development, and research education funding opportunity announcements (see, for example, PA-06-048).
  • Addition of a standardized list of specialty boards.

Effective date: The Statement of Appointment Form (revised 11/2007) may be used immediately and MUST be used for all trainee appointments made on or after May 1, 2008.

PHS 3734 (Official Statement Relinquishing Interest and Rights in a PHS Research Grant)

There are no changes to the data elements or instructions of the PHS 3734 at this time.
Effective date: This version (11/2007) may be used immediately.

HHS 568 (Final Invention Statement and Certification)

There is only one notable change. The requirement for the signature of the Principal Investigator or Program Director is eliminated. Only the signature of an official authorized to sign on behalf of the institution is required.

Effective date: This version (11/2007) may be used immediately.


General inquires about the changes to these forms may be directed to:

Grants Info
Office of Extramural Research
National Institutes of Health
Telephone: 301-945-7573
TTY: 301-451-5936