APPLICATION FORM NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM

ICR 198108-0935-003

OMB: 0935-0015

Federal Form Document

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Document
Name
Status
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ICR Details
0935-0015 198108-0935-003
Historical Active 198007-0935-002
HHS/AHRQ
APPLICATION FORM NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM
No material or nonsubstantive change to a currently approved collection   No
Emergency 08/31/1981
Approved with change 08/31/1981
Retrieve Notice of Action (NOA) 08/31/1981
  Inventory as of this Action Requested Previously Approved
11/30/1981 11/30/1981 08/31/1981
10,000 0 10,000
5,000 0 5,000
0 0 0

PL 94-484 AUTHORIZED THE NHSC SCHOLARSHIP PROGRAM, DESIGNATED AS SECTIONS 751 AND 756 OF THE PHS ACT. TO BE ELIGIBLE TO PARTICIPATE IN THE SCHALORSHIP PROGRAM, SECTION 751, PROVIDES THAT AN INDIVIDUAL MUST SUBMIT AN APPLICATION TO PARTICIPATE IN THE SCHOLARSHIP PROGRAM. THE INFORMATION WILL BE USED BY THE SCHOLARSHIP SELECTION COMMITTEE TO DETERMINE WHICH APPLICANTS WILL BE OFFERED SCHOLARSHIPS AND WILL BE USED FOR THE IDENTIFICATION AND NOTIFICATION OF RECIPIENTS

None
None


No

1
IC Title Form No. Form Name
APPLICATION FORM NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM HRA98-1

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,000 10,000 0 0 0 0
Annual Time Burden (Hours) 5,000 5,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/31/1981


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