APPLICATION FOR APPOINTMENT AS A COMMISSIONED OFFICER IN THE U.S. PUBLIC HEALTH SERVICE

ICR 198212-0937-001

OMB: 0937-0025

Federal Form Document

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Document
Name
Status
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IC Document Collections
ICR Details
0937-0025 198212-0937-001
Historical Active 197805-0937-001
HHS/OASH
APPLICATION FOR APPOINTMENT AS A COMMISSIONED OFFICER IN THE U.S. PUBLIC HEALTH SERVICE
Revision of a currently approved collection   No
Regular
Approved without change 03/22/1983
Retrieve Notice of Action (NOA) 12/23/1982
Approved for two years contingent upon the submission to OMB and acceptance of HHS Commissioned Corps selection criteria, not later than July 31,1983. In addition HHS General Counsel will determine whether it is appropriate to include an item on sex
  Inventory as of this Action Requested Previously Approved
03/31/1985 03/31/1985 05/31/1983
17,600 0 20,224
6,350 0 5,056
0 0 0

THE FORMS WILL BE USED BY INDIVIDUALS TO APPLY FOR APPOINTMENT IN THE COMMISSIONED CORPS OF THE PUBLIC HEALTH SERVICE (PHS) AND TO OBTAIN REFERENCES AS PART OF THAT APPLICATION PROCESS. INFORMATION SUPPLIED ON THE FORMS WILL BE USED BY APPROPRIATE PHS OFFICIALS TO EVALUATE CANDIDATES FOR APPOINTMENT.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR APPOINTMENT AS A COMMISSIONED OFFICER IN THE U.S. PUBLIC HEALTH SERVICE PHS-50 &, PHS-1813

  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 17,600 20,224 0 9,328 -11,952 0
Annual Time Burden (Hours) 6,350 5,056 0 -4,600 5,894 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
12/23/1982


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