Application for Participation in the National Health Service Corps Scholarship Program

Forms and Documents

Document	Type	Status	Availability
Form nhsc 0146 Application for Participation in the National Health Service Corps Scholarship Program	Form	Modified	Repair queued
terms_0146_2007.wpd	Supplementary Document	Uploaded 0000-00-00	Available
ss 0146 2007.doc	Supporting Statement A	Uploaded 0000-00-00	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
6375	Application for Participation in the National Health Service Corps Scholarship Program	Form	Modified

ICR Details

OMB Control No: 0915-0146	ICR Reference No: 200702-0915-003
Status: Historical Inactive	Previous ICR Reference No: 200307-0915-005
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Application for Participation in the National Health Service Corps Scholarship Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 06/05/2007
	Date Received in OIRA: 02/20/2007
Terms of Clearance: This ICR is withdrawn as requested by HRSA. When resubmitting this ICR, HRSA shall respond fully to comments and questions raised in passbacks with HRSA.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2007	36 Months From Approved	06/30/2007
Responses	3,100	0	3,100
Time Burden (Hours)	3,100	0	3,100
Cost Burden (Dollars)	8,000	0	8,000

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Abstract: The National Health Service Corps (NHSC) Scholarship Program offers scholarship awards to health professions students in return for the provision of full-time clinical services in a federally designated Health Professional Shortage Area. The NHSC Scholarship application collects information to select applicants for scholarship awards. The application information is necessary in order to determine those applicants that meet award criteria specified by Federal statute and regulation.

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Authorizing Statute(s): US Code: 42 USC 254 Name of Law: National Health Service Corps
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 7979	02/15/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 3865	01/26/2007
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
Application for Participation in the National Health Service Corps Scholarship Program	nhsc 0146	nhsc scholarship application

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Cutting Redundancy

Short Statement: The NHSC Scholarship program will no longer conduct a personal interview as part of the application and selection process for awards. The progam has discontinued the interview portion of this information collection. This program change has resulted in a reduction of burden on respondents.

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Annual Cost to Federal Government: $53,225

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: 02/20/2007

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