Information Collection

Scholarships for Disadvantaged Students (SDS) Program Application Form

IC 6377 under ICR 201612-0915-003 · OMB 0915-0149.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0149 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Scholarships for Disadvantaged Students (SDS) Program Application Form	Form and Instruction
SDS Program Specific Form- Instructions.docx	Instruction
1 SDS Program Specific Form.pdf SDS Program Specific Form.pdf	Form and Instruction

IC Title:

Scholarships for Disadvantaged Students (SDS) Program Application Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	1	SDS Program Specific Form.pdf	SDS Program Specific Form.pdf		Yes	Yes	Fillable Fileable
Instruction			SDS Program Specific Form- Instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 40

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	5,200	5,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.