NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM APPLICATION

ICR 199201-0915-003

OMB: 0915-0146

Federal Form Document

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Document
Name
Status
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ICR Details
0915-0146 199201-0915-003
Historical Active 199101-0915-002
HHS/HSA
NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM APPLICATION
Revision of a currently approved collection   No
Regular
Approved without change 04/28/1992
Retrieve Notice of Action (NOA) 01/31/1992
  Inventory as of this Action Requested Previously Approved
06/30/1995 06/30/1995 04/30/1992
5,000 0 3,000
5,000 0 3,000
0 0 0

HEALTH PROFESSIONS STUDENTS APPLYING FOR NATIONAL HEALTH SERVICE CORPS SCHOLARSHIPS PROVIDE INFORMATION NEEDED TO DETERMINE ELIGIBILITY FOR T PROGRAM.

None
None


No

1
IC Title Form No. Form Name
NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM APPLICATION HRSA 856

  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 5,000 3,000 0 2,000 0 0
Annual Time Burden (Hours) 5,000 3,000 0 2,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
01/31/1992


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