OMB
.report
Search
NURSE Corps LRP Application
NURSE Corps Loan Repayment Program
OMB: 0915-0140
IC ID: 6368
OMB.report
HHS/HSA
OMB 0915-0140
ICR 202212-0915-001
IC 6368
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0140 can be found here:
2023-01-05 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
NURSE Corps LRP Application
Form and Instruction
Form 1
NURSE Corps LRP Application
Form and Instruction
1 NC LRP - Application Form - Revised.docx
NC LRP - Application Form - Revised.docx
Form and Instruction
1 NC LRP - Application Form - Revised.docx
NC LRP - Application Form - Revised.docx
Form and Instruction
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide
IC Document
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NURSE Corps LRP Application
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
5 CFR 1320.5(d)(2)
31 CFR 208, 210 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
NC LRP - Application Form - Revised.docx
NC LRP - Application Form - Revised.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
Public Health Service and National Health Service Corps Scholarship/Loan Repayment Participants Records System
FR Citation:
58 FR 12968
Number of Respondents:
7,100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
7,100
0
0
0
0
7,100
Annual IC Time Burden (Hours)
14,200
0
0
0
0
14,200
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf
02/04/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.