Information Collection

IHS Scholarship Program Application

IC 6561 under ICR 200111-0917-002 · OMB 0917-0006.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

IHS Scholarship Program Application

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	F-02	No	No
Form	F-04	No	No
Form	D-02	No	No
Form	G-04	No	No
Form	856-2--856-8	No	No
Form	G-02	No	No
Form	H-08	No	No
Form	H-07	No	No
Form	IHS-856	No	No
Form	IHS-815-818	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15,830

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
Annual Number of Responses for this IC	15,830	15,830
Annual IC Time Burden (Hours)	7,356	7,356
Annual IC Cost Burden (Dollars)	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.