Information Collection

Application For Participation In The National Health Service Corps Scholarship Program The Indian Health Service Scholarship Program

IC 110232 under ICR 198610-0915-002 · OMB 0915-0072.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR PARTICIPATION IN THE NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM THE INDIAN HEALTH SERVICE SCHOLARSHIP PROGRAM	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HRSA-856				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,910	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,910	1,310	600
Annual IC Time Burden (Hours)	1,910	1,310	600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.