Information Collection

Verification of Acceptance or Decline of Award

IC 183613 under ICR 201006-0917-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form IHS-856-7 Verification of Acceptance or Decline of Award Form
IHS-856-7 Verification of Acceptance or Decline of Award IHS-856-7 VERF ACCEP DECLINE.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Verification of Acceptance or Decline of Award	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	IHS-856-7	Verification of Acceptance or Decline of Award	IHS-856-7 VERF ACCEP DECLINE.pdf		No	No	Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: IHS Scholarship Program	FR Citation: 72 FR 5446

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	400	375	25
Annual IC Time Burden (Hours)	53	32	21
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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