The need and purpose of this
information collection is to obtain information to consider
applicants for a Faculty Loan Repayment Program contract award.
Applicants must submit a Disadvantaged Background Form as a
requirement of the application to determine the applicant’s
eligibility to participate in the program and competitiveness in
rank for award funding. Respondents include individuals who have a
health professions degree or certificate to serve as faculty
members in eligible, accredited health professions
schools.
PL:
Pub.L. 105 - 392 738(a) Name of Law: Health Professions
Education Partnerships Act of 1998
US Code: 42
USC 293b Name of Law: Public Health Service Act
The increase in burden is due
to an increase in estimated responses and the addition of the
Disadvantaged Background form to this information collection
request.
$201,372
No
Yes
Yes
No
No
No
No
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.