Scholarships for Disadvantaged Students Application Program Specific Form

ICR 201612-0915-003

OMB: 0915-0149

Federal Form Document

Forms and Documents
ICR Details
0915-0149 201612-0915-003
Historical Active 201311-0915-004
HHS/HSA 20517
Scholarships for Disadvantaged Students Application Program Specific Form
Revision of a currently approved collection   No
Regular
Approved with change 03/03/2017
Retrieve Notice of Action (NOA) 12/08/2016
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved 03/31/2017
400 0 598
5,200 0 9,952
0 0 0

Information collected for the SDS application is needed by the Department to identify interested applicants to the Program. It is used to determine whether applicant schools meet the requirements of enabling legislation, to determine eligibility for program participation, and to establish priority points for funding. Each school will determine the eligibility of students based on financial need and whether a student is from a disadvantaged background. Eligible applicants are accredited schools of medicine, osteopathic medicine, dentistry, nursing, pharmacy, podiatric medicine, optometry, veterinary medicine, public health, chiropractic, allied health, a school offering a graduate program in behavioral and mental health practice, or an entity providing programs for the training of physician assistants.

PL: Pub.L. 111 - 148 7101 Name of Law: Affordable care Act of 2010
   PL: Pub.L. 105 - 392 737 Name of Law: Scholarships for Disadvantaged Students
   US Code: 42 USC 293a Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  81 FR 46941 07/19/2016
81 FR 86720 12/01/2016
No

  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 400 598 0 0 -198 0
Annual Time Burden (Hours) 5,200 9,952 0 0 -4,752 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There is a decrease in burden as a form has been removed from this revision, thus reducing the burden for this ICR.

$26,400
No
No
Yes
No
No
Uncollected
Elyana Bowman 301 443-3983 enadjem@hrsa.gov

  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.
12/08/2016


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