Revised PHS 416-5, PHS 416-7, PHS 6031 AND PHS 6031-1 Forms for the Ruth L. Kirschstein NRSA Now Available

Notice Number: NOT-OD-09-006

Key Dates
Release Date: October 14, 2008

Issued by
National Institutes of Health (NIH), (
Agency for Healthcare Research and Quality (AHRQ),

NIH announces the availability of four revised (Rev. 9/08) forms associated with the Kirschstein-NRSA process:

1) PHS 416-5 (Activation Notice)
2) PHS 416-7 (Termination Notice)
3) PHS 6031 (Payback Agreement)
4) PHS 6031-1(Annual Payback Activities Certification)

The revised forms and instructions are available at . The forms continue to be provided in two formats—MS Word and PDF-fillable using Adobe Acrobat Reader Software. Free Adobe Software may be accessed at .
There are no changes of note to the PHS 416-5, PHS 416-7, PHS 6031 and PHS 6031-1 Forms. Instructional text has been updated for clarity.

Effective Date:  The 9/08 version is available and required for immediate use.  Any supply of the previous versions should no longer be used. 


Inquiries on any changes to the forms and instructions may be directed to:

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