OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Participant Semi-Annual Employment Verification Form

IC 182803 under ICR 201804-0915-004 · OMB 0915-0140.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Participant Semi-Annual Employment Verification Form
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR Part 57 Section 312 31 CFR 208, 210 5 CFR 1320.8(d)  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 NCLRP CSF Verification NURSE CORPS LOAN REPAYMENT PROGRAM (Nurse Corps LRP) EMPLOYMENT VERIFICATION AND CRITICAL SHORTAGE FACILITY FORM.docx Yes Yes Fillable Fileable
Form and Instruction 4 NCLRP NURSE Faculty Verification NURSE CORPS LOAN REPAYMENT PROGRAM (Nurse Corps LRP) EMPLOYMENT VERIFICATION FOR NURSE FACULTY.docx Yes Yes Fillable Fileable
Form and Instruction 5 Participant Semi-Annual Employment Verification Form Six Month ISV Form.docx Yes Yes Fillable Fileable

Health Health Care Services

Public Health Service and National Health Service Corps Scholarship/Loan Repayment Participants Records System  58 FR 12968

8,600 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 16,400 0 11,800 0 0 4,600
Annual IC Time Burden (Hours) 13,955 0 11,655 0 0 2,300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.