NHHSP Scholar Enrollment Verification Form

The National Health Service Corps Scholarship Program, Students to Service Loan Repayment Program, and the Native Hawaiian Health Scholarship Program

OMB: 0915-0146

IC ID: 242294

Information Collection (IC) Details

View Information Collection (IC)

NHHSP Scholar Enrollment Verification Form
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 4-5 NHHSP Scholar Enrollment Verification Form.pdf NHHSP Scholar Enrollment Verification Form.pdf Yes No Fillable Printable

Health Health Care Services

 

30 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 225 0 225 0 0 0
Annual IC Time Burden (Hours) 113 0 113 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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