NURSE Corps Loan Repayment Program

ICR 202212-0915-001

OMB: 0915-0140

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0915-0140 can be found here:

2023-01-05 - Extension without change of a currently approved collection

Forms and Documents

Document Name	Status
Form 1 NURSE Corps LRP Application Form and Instruction	Unchanged
Form 1 NURSE Corps LRP Application Form and Instruction	Unchanged
Form 8 Nurse Corps Nurse Faculty Employment Verification Form Form and Instruction	Unchanged
Form 8 Nurse Corps Nurse Faculty Employment Verification Form Form and Instruction	Unchanged
Form 7 Nurse Corps Crtiical Shortage Facility (CSF) Verification Form Form and Instruction	Unchanged
Form 7 Nurse Corps Crtiical Shortage Facility (CSF) Verification Form Form and Instruction	Unchanged
Form 6 Participant Semi-Annual in Service Verification Form Form and Instruction	Unchanged
Form 6 Participant Semi-Annual in Service Verification Form Form and Instruction	Unchanged
Form 5-1 Confirmation of Interest Form Form and Instruction	Unchanged
Form 5-1 Confirmation of Interest Form Form and Instruction	Unchanged
Form 4 Disadvantaged Background Form Form and Instruction	Unchanged
Form 4 Disadvantaged Background Form Form and Instruction	Unchanged
Form 2 Authorization to Release Information Form Form and Instruction	Unchanged
Form 2 Authorization to Release Information Form Form and Instruction	Unchanged
Form 3 Employment Verification Form Form and Instruction	Unchanged
Form 3 Employment Verification Form Form and Instruction	Unchanged
Nurse Corps LRP 60-day FRN.pdf Supplementary Document	2020-02-04
Nurse Corps LRP 60-day FRN.pdf Supplementary Document	2020-02-04
NC LRP - Supporting Statement A.docx Supporting Statement A	2020-02-04
NC LRP - Supporting Statement A.docx Supporting Statement A	2020-02-04

IC Document Collections

IC ID	Document Title	Status
6368	NURSE Corps LRP Application Form and Instruction	Unchanged
6368	NURSE Corps LRP Application Form and Instruction	Unchanged
239781	Nurse Corps Nurse Faculty Employment Verification Form Form and Instruction	Unchanged
239781	Nurse Corps Nurse Faculty Employment Verification Form Form and Instruction	Unchanged
239779	Nurse Corps Crtiical Shortage Facility (CSF) Verification Form Form and Instruction	Unchanged
239779	Nurse Corps Crtiical Shortage Facility (CSF) Verification Form Form and Instruction	Unchanged
239777	Participant Semi-Annual in Service Verification Form Form and Instruction	Unchanged
239777	Participant Semi-Annual in Service Verification Form Form and Instruction	Unchanged
239776	Confirmation of Interest Form Form and Instruction	Unchanged
239776	Confirmation of Interest Form Form and Instruction	Unchanged
239775	Disadvantaged Background Form Form and Instruction	Unchanged
239775	Disadvantaged Background Form Form and Instruction	Unchanged
239774	Authorization to Release Information Form Form and Instruction	Unchanged
239774	Authorization to Release Information Form Form and Instruction	Unchanged
182803	Employment Verification Form Form and Instruction	Unchanged
182803	Employment Verification Form Form and Instruction	Unchanged

ICR Details