NHSC Recruitment and Retention Assistance Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0230 can be found here:

Documents and Forms

Document Name Document Type
Form 0230 NHSC Recruitment and Retention Assistance Application Form
0230 instructions 08.doc Instruction
0230 site application 0230 Application 2008 omb.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NHSC Recruitment and Retention Assistance Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0230	site application	0230 Application 2008 omb.doc		Yes	Yes	Fillable Fileable
Instruction			0230 instructions 08.doc		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,900	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,900	2,900
Annual IC Time Burden (Hours)	1,450	1,450
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.