Form 1 Grantee Entrollment Screenshot from HSES

OMB Control No: 0970-0427
Expiration date: X/XX/XXXX

Monthly Enrollment

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)
Public reporting burden for this collection of information is estimated to average 0.05 hours per response,
including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing
the collection of information.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.

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