Information Collection

H-1B Rural Healthcare Grant Program FOA

IC 243539 under ICR 201905-1225-001 · OMB 1225-0086.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0086 can be found here:

Documents and Forms

Document Name Document Type
Form FOA-ETA-20-12 H-1B Rural Healthcare Grant Program FOA Form and Instruction
FOA-ETA-20-12 H-1B Rural Heathcare Grant Program FOA H-1B Rural Healthcare Grant Program FOA.docx Form and Instruction
H-1B Rural Healthcare Grant Program Supporting Statement.docx H-1B Rural Healthcare Grant Program Supporting Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	H-1B Rural Healthcare Grant Program FOA	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FOA-ETA-20-12	H-1B Rural Heathcare Grant Program FOA	H-1B Rural Healthcare Grant Program FOA.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
H-1B Rural Healthcare Grant Program Supporting Statement	H-1B Rural Healthcare Grant Program Supporting Statement.docx	09/08/2020

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