Application for Participation in the IHS Scholarship Program

ICR 199805-0917-001

OMB: 0917-0006

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
0917-0006 199805-0917-001
Historical Active 199802-0917-002
HHS/IHS
Application for Participation in the IHS Scholarship Program
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/19/1998
Retrieve Notice of Action (NOA) 05/19/1998
  Inventory as of this Action Requested Previously Approved
04/30/2001 04/30/2001 04/30/2001
11,730 0 1
5,390 0 5,395
0 0 0

The IHS Scholarship Program forms collect information that is used to solicit, process, and award scholarships; monitor the academic performance of awardees; and place awardees at payback sites. The data is needed to plan, manage, direct, operate, and evaluate the IHS Scholarship Program.

None
None


No

1
IC Title Form No. Form Name
Application for Participation in the IHS Scholarship Program IHS-856, 856-2-856-8, IHS-818, D-02, F-02, F-04, G-02, G-04, H-07-H-08, J-04-J-05

  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 11,730 1 0 11,729 0 0
Annual Time Burden (Hours) 5,390 5,395 0 -5 0 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.
05/19/1998


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