Information Collection

Application for Participation in the IHS Scholarship Program

IC 37702 under ICR 199805-0917-001 · OMB 0917-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Application for Participation in the IHS Scholarship Program

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	856-2-856-8	No	No
Form	G-04	No	No
Form	H-07-H-08	No	No
Form	IHS-818	No	No
Form	J-04-J-05	No	No
Form	G-02	No	No
Form	F-02	No	No
Form	F-04	No	No
Form	D-02	No	No
Form	IHS-856	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,730

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,730	11,729	1
Annual IC Time Burden (Hours)	5,390	-5	5,395
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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