NATIONAL HEALTH SERVICE CORPS APPLICATION FOR PLACEMENT OF PERSONNEL

ICR 198105-0915-001

OMB: 0915-0010

Federal Form Document

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Name
Status
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ICR Details
0915-0010 198105-0915-001
Historical Active 198103-0915-002
HHS/HSA
NATIONAL HEALTH SERVICE CORPS APPLICATION FOR PLACEMENT OF PERSONNEL
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 06/08/1981
Retrieve Notice of Action (NOA) 05/07/1981
  Inventory as of this Action Requested Previously Approved
08/31/1983 08/31/1983
150 0 0
525 0 0
0 0 0

THIS APPLICATION IS SUBMITTED TO THE FEDERAL GOVERNMENT BY AN ENTITY IN A HEALTH MANPOWER SHORTAGE AREA WHICH SEEKS ASSIGNMENT OF NHSC PERSONNEL. INFORMATION IN THE APPLICATION HELPS THE GOVERNMENT TO DETERMINE WHETHER TO ASSIGN NHSC PERSONNEL.

None
None


No

1
IC Title Form No. Form Name
NATIONAL HEALTH SERVICE CORPS APPLICATION FOR PLACEMENT OF PERSONNEL

  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 150 0 0 0 150 0
Annual Time Burden (Hours) 525 0 0 0 525 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.
05/07/1981


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