GRANT PROGRAM FOR SCHOLARSHIPS FOR THE UNDERGRADUATE EDUCATION OF PROFESSIONAL NURSES - FORMS

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
110355	GRANT PROGRAM FOR SCHOLARSHIPS FOR THE UNDERGRADUATE EDUCATION OF PROFESSIONAL NURSES - FORMS	Migrated

ICR Details

OMB Control No: 0915-0141	ICR Reference No: 199007-0915-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: GRANT PROGRAM FOR SCHOLARSHIPS FOR THE UNDERGRADUATE EDUCATION OF PROFESSIONAL NURSES - FORMS
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/24/1990
	Date Received in OIRA: 07/26/1990
Terms of Clearance: This information collection is approved for use until September 30, 1991. OMB remains concerned about whether the scholarship contract is indeed a "legally enforceable document" as stated by HHS Office of General Counsel (see October 22, 1990 memorandum from the Director, Office of Program Development, BHP, HRSA to HRSA Desk Officer, OIRA, OMB). There are many contractual terms lacking definition, thus raising concerns that the scholarship recipients may not have full knowledge of the terms and conditions of the agreement they are asked to enter (e.g., "full-time", "critical shortage of nurses", conditions for the waiver of service obligation, terms of repayment for failure to meet service obligation, and "assistance" from HHS in identifying facilities for full-time employment). OMB recommends that HHS/HRSA initiate rulemaking for the proper implementation of this program as it has done for similar programs. ********** The forms should cite at the beginning the relevant statute, regulations or policies governing the operation of this program. HRSA should also consider whether the program forms are in compliance with the Privacy Act of 1974 requiring the agency to provide notification to individuals asked to supply information (see HRSA's NHSC program, OMB# 0915-0127).

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1991	09/30/1991
Responses	4,300	0	0
Time Burden (Hours)	1,100	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THE FIRST FORM IS FOR NURSING STUDENTS TO APPLY FOR ASSISTANCE AND ALS WILL SERVE AS A CONTRACT BETWEEN THE STUDENT AND DHHS STATING THAT THE STUDENT WILL FULFILL THE PRACTICE OBLIGATION. THE SECOND FORM WILL BE USED TO TRACK THE COMPLIANCE OF RECIPIENTS DURING THE OBLIGATED PRACTI PERIOD.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
GRANT PROGRAM FOR SCHOLARSHIPS FOR THE UNDERGRADUATE EDUCATION OF PROFESSIONAL NURSES - FORMS

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ICR Summary of Burden

	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	4,300	0	0	4,300	0	0
Annual Time Burden (Hours)	1,100	0	0	1,100	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/26/1990

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