Information Collection

Scholarship Application

IC 6562 under ICR 200801-0917-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form multiple forms Scholarship Application	Form and Instruction
multiple forms Student Handbook Scholarship_Handbook_OMB.pdf	Form and Instruction
multiple forms Application Handbook Scholarship_Applicant_Handbook_OMB.pdf	Form and Instruction
856.pdf form ihs-856	IC Document

IC Title:

Scholarship Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 3506

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	multiple forms	Student Handbook	Scholarship_Handbook_OMB.pdf		Yes	No	Fillable Printable
Form and Instruction	multiple forms	Application Handbook	Scholarship_Applicant_Handbook_OMB.pdf		Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: IHS Scholarship Program

FR Citation: 72 FR 5446

Number of Respondents: 1,500

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,500	-15,830	17,330
Annual IC Time Burden (Hours)	1,500	-4,036	5,536
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
form ihs-856	856.pdf	12/04/2007

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