NHSC SUPPLEMENTAL MANPOWER APPLICATION

ICR 197805-0915-001

OMB: 0915-0007

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
110044
Migrated
ICR Details
0915-0007 197805-0915-001
Historical Active
HHS/HSA
NHSC SUPPLEMENTAL MANPOWER APPLICATION
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/09/1978
Retrieve Notice of Action (NOA) 05/09/1978
  Inventory as of this Action Requested Previously Approved
10/31/1981 10/31/1981
200 0 0
400 0 0
0 0 0

APPLICANTS FOR, AND HOLDERS OF, BCHS GRANTS USE THIS FORM FOR REQUESTING NATIONAL HEALTH SERVICE CROPS PERSONNEL. APPLICANTS' COMPLETION OF THE FORM INCLUDES COORDINATION OF COMMENTS FROM THE APPROPRIATE HEALTH SYSTEM AGENCY AND LOCAL PROFESSIONAL SOCIETIES.

None
None


No

1
IC Title Form No. Form Name
NHSC SUPPLEMENTAL MANPOWER APPLICATION

  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 200 0 0 0 200 0
Annual Time Burden (Hours) 400 0 0 0 400 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
05/09/1978


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