DOCUMENTATION OF FORMAL EDUCATIONAL ASSISTANCE AGREEMENT (EAA)

ICR 198610-0915-003

OMB: 0915-0113

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
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ICR Details
0915-0113 198610-0915-003
Historical Active
HHS/HSA
DOCUMENTATION OF FORMAL EDUCATIONAL ASSISTANCE AGREEMENT (EAA)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/10/1986
Retrieve Notice of Action (NOA) 10/01/1986
  Inventory as of this Action Requested Previously Approved
09/30/1989 09/30/1989
40 0 0
120 0 0
0 0 0

CLEARANCE IS REQUESTED TO REQUIRE DOCUMENTATION OF A FORMAL EDUCATIONAL ASSISTANCE AGREEMENT (EAA) BY AN APPLICANT FOR A HEALTH CAREERS OPPORTUNITY PROGTAM (HCOP) GRANT WHO SEEK TO QUALIFY FOR BONUS POINTS UNDER AN EAA FUNDING PERFERENCE.

None
None


No

1
IC Title Form No. Form Name
DOCUMENTATION OF FORMAL EDUCATIONAL ASSISTANCE AGREEMENT (EAA)

  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 40 0 0 0 40 0
Annual Time Burden (Hours) 120 0 0 0 120 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.
10/01/1986


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