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

ICR 198801-0937-004

OMB: 0937-0025

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0937-0025 198801-0937-004
Historical Active 198412-0937-005
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 04/24/1988
Retrieve Notice of Action (NOA) 01/28/1988
Approved with additional debt question.
  Inventory as of this Action Requested Previously Approved
03/31/1991 03/31/1991 03/31/1988
9,000 0 8,500
3,600 0 3,400
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 9,000 8,500 0 500 0 0
Annual Time Burden (Hours) 3,600 3,400 0 200 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
01/28/1988


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