Information Collection

Application For Appointment As A Commissioned Officer In The U.s. Public Health Service

IC 112245 under ICR 199403-0937-002 · OMB 0937-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0937-0025 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR APPOINTMENT AS A COMMISSIONED OFFICER IN THE U.S. PUBLIC HEALTH SERVICE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PHS-50 &				No	No
Form	PHS-1813				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 21,225	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	21,225	3,725	17,500
Annual IC Time Burden (Hours)	8,450	1,450	7,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.