Phs-1813

Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps

OMB: 0937-0025

IC ID: 46578

Documents and Forms
Document Name
Document Type
Other-Reference Form
Information Collection (IC) Details

View Information Collection (IC)

PHS-1813
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 21.28 42 CFR 21.34 42 CFR 21.22 42 CFR 21.58

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Reference Form PHS-1813 Commissioned Corps Reference Form_12-14-16.pdf Yes Yes Fillable Fileable

Health Health Care Services

PHS Commissioned Corps General Personnel Records  63 FR 68596

4,000 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 4,000 0 0 0 0 4,000
Annual IC Time Burden (Hours) 1,000 0 0 0 0 1,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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