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5-3 NC LRP COI 3-Sign your Electronic Contract Page - Revise
NURSE Corps Loan Repayment Program
NC LRP COI 3-Sign your Electronic Contract Page - Revised
Confirmation of Interest Form
OMB: 0915-0140
OMB.report
HHS/HSA
OMB 0915-0140
ICR 202212-0915-001
IC 239776
5-3 NC LRP COI 3-Sign your Electronic Contract Page - Revise
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0915-0140 can be found here:
2025-08-13 - Revision of a currently approved collection
2023-01-05 - Extension without change of a currently approved collection
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