DOCUMENTATION OF FORMAL EDUCATIONAL ASSISTANCE AGREEMENT (EAA)

ICR 198904-0915-004

OMB: 0915-0113

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0915-0113 198904-0915-004
Historical Active 198904-0915-002
HHS/HSA
DOCUMENTATION OF FORMAL EDUCATIONAL ASSISTANCE AGREEMENT (EAA)
No material or nonsubstantive change to a currently approved collection   No
Emergency 04/04/1989
Approved with change 04/04/1989
Retrieve Notice of Action (NOA) 04/04/1989
  Inventory as of this Action Requested Previously Approved
09/30/1989 09/30/1989 09/30/1989
40 0 40
120 0 120
0 0 0

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

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 40 0 0 0 0
Annual Time Burden (Hours) 120 120 0 0 0 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.
04/04/1989


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