CREDENTIALS EVALUATION OF HEALTH CARE PRACTITIONERS (PREVIOUSLY LABELED "RELEVANT PERSONNAL & PROFESSIONAL INFO TO ENABLE THE AFMS TO MAKE DECISIONS ABOUT AWARDING,ETC
ICR 198805-0701-002
OMB: 0701-0097
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0701-0097 can be found here:
CREDENTIALS EVALUATION OF
HEALTH CARE PRACTITIONERS (PREVIOUSLY LABELED "RELEVANT PERSONNAL
& PROFESSIONAL INFO TO ENABLE THE AFMS TO MAKE DECISIONS ABOUT
AWARDING,ETC
PRACTITIONERS SEEKING T JOIN OR BE
EMPLOYED BY THE AIR FORCE TO PROVIDE PATIENT CARE MUST PROVIDE
PERSONAL AND PROFESSIONAL INFORMATION SO THAT THEIR QUALIFICATIONS
TO DO SO MAY BE OBJECTIVELY EVALUATED.
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.