NURSE PRACTITIONER AND NURSE MIDWIFERY TRAINEESHIP PROGRAM

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
110337	NURSE PRACTITIONER AND NURSE MIDWIFERY TRAINEESHIP PROGRAM	Migrated

ICR Details

OMB Control No: 0915-0129	ICR Reference No: 199007-0915-003
Status: Historical Active	Previous ICR Reference No: 198906-0915-010
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: NURSE PRACTITIONER AND NURSE MIDWIFERY TRAINEESHIP PROGRAM
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/19/1990
	Date Received in OIRA: 07/23/1990
Terms of Clearance: This information collection is approved for use until September 30, 1991. OMB conditionally approves the forms with the agreement that the agency must submit final versions of the forms which reflect amendments agreed to in the October 17, 1990 Note to Angela Antonelli, OMB from Nancy Pearce, PHS. This should include the agency's counsel written concurrence that the terms of the contract and other forms are consistent with relevant regulations. All of the forms (HRSA 950-955) should cite at the beginning the statutes and regulations governing the operation of the Nurse Practitioner and Nurse Midwifery Traineeship Programs. HRSA should 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 forms, OMB no. 0915-0127). In addition, HRSA should examine the extent to which the program forms can be consolidated (e.g., HRSA 953 and 955) and still meet the requirements of program regulations. HRSA should seek consultation on the forms before the next submission to OMB.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1991	09/30/1991	09/30/1990
Responses	1,736	0	1
Time Burden (Hours)	370	0	1
Cost Burden (Dollars)	0	0	0

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Abstract: CLEARANCE IS REQUESTED TO MOVE THE NPRM TO FINAL RULE AND FINALIZE THE RESPONSE BURDEN. APPROVAL IS NEEDED FOR FIVE FORMS NEEDED TO OPERATE THE PROGRAM AND TRACK THE RECIPIENTS THROUGH THE OBLIGATORY SERVICE PERIOD. THE DATA ARE PROVIDED BY TRAINING PROGRAMS, THE TRAINEES AND THE EMPLOYERS.

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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
NURSE PRACTITIONER AND NURSE MIDWIFERY TRAINEESHIP PROGRAM

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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	1,736	1	0	1,735	0	0
Annual Time Burden (Hours)	370	1	0	369	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: 07/23/1990

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