The Nursing Scholarship Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NSP_001 The Nursing Scholarship Program	Form and Instruction	Modified	Available
Attachment F - Employment Certification Form.pdf	Supplementary Document	Uploaded 2009-07-17	Available
Attachment D - NSP School Verification Sheet 2009.pdf	Supplementary Document	Uploaded 2009-07-17	Available
Attachment C - Nursing Scholarship Program Applicant Information Bulletin.pdf	Supplementary Document	Uploaded 2009-07-17	Available
Attachment B - Nursing Scholarship Program Application FY 09 Screen Shots.pdf	Supplementary Document	Uploaded 2009-07-17	Available
Attachment A - NSP & NELRP Legislation.pdf	Supplementary Document	Uploaded 2009-07-17	Available
ss 0301_2009_final.pdf	Supporting Statement A	Uploaded 2009-07-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43610	The Nursing Scholarship Program	Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0301	ICR Reference No: 200907-0915-002
Status: Historical Active	Previous ICR Reference No: 200605-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: The Nursing Scholarship Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/15/2009
	Date Received in OIRA: 07/24/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2012	36 Months From Approved	09/30/2009
Responses	5,100	0	5,000
Time Burden (Hours)	10,200	0	4,750
Cost Burden (Dollars)	0	0	0

---

Abstract: The Nursing Scholarship Program's purpose is to provide scholarships to nursing students in exchange for a service commitment at an eligible health facility with a critical shortage of nurses. Under this program, students seeking to become registered nurses are offered the opportunity to enter into a contractural agreement under which HHS agrees to pay the total school tuition required fees, and a stipent for living expenses.

---

Authorizing Statute(s): US Code: 42 USC 846 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 67526	11/14/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 32935	07/09/2009
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
The Nursing Scholarship Program	NSP_001	Nursing Scholarship Program Application Screenshots

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,100	5,000	0	0	100	0
Annual Time Burden (Hours)	10,200	4,750	0	0	5,450	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $238,125

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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 07/24/2009

---