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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.