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

ICR 202008-0937-001

OMB: 0937-0025

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2020-10-14
Supporting Statement A
2020-10-14
IC Document Collections
ICR Details
0937-0025 202008-0937-001
Active 201911-0937-001
HHS/OASH
Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps
Revision of a currently approved collection   No
Regular
Approved without change 12/30/2020
Retrieve Notice of Action (NOA) 10/14/2020
  Inventory as of this Action Requested Previously Approved
12/31/2023 36 Months From Approved 02/28/2023
17,500 0 16,000
3,792 0 3,500
42,000 0 36,000

The forms will be used by individuals to apply for appointment in the U.S. Public Health Service Commissioned Corps and to obtain references as part of the application process. Information supplied on the forms will be used by appropriate Department officials to evaluate candidates for appointment.

US Code: 37 USC 101 Name of Law: (3)
  
None

Not associated with rulemaking

  85 FR 46679 08/03/2020
85 FR 65054 10/14/2020
No

4
IC Title Form No. Form Name
PHS-50
PHS-1813
Interested Health Professionals
Addendum: Commissioned Corps Personal Statement

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 17,500 16,000 0 1,500 0 0
Annual Time Burden (Hours) 3,792 3,500 0 292 0 0
Annual Cost Burden (Dollars) 42,000 36,000 0 6,000 0 0
Yes
Changing Regulations
Yes
Using Information Technology
This is a modification request due to a program adjustment of hours as a result of implementation of the Ready Reserve Corps. The modification of Table 12 includes the additional burden hours for the Ready Reserve. A newly implemented digital application process which allows for opening the application to all interested health professional to include: Medical, Dental, Nurse, Pharmacy, Scientist, Dietician, Therapist, Health Services, Engineer, Environmental Health and Veterinarians which increased the number of respondents from 3,000 to 3,500. The implementation of the Ready Reserve increases the number of interested health professionals by 1,000 and as a result increasing the burden hours as reflected in Table 12A. There are no changes to how candidates receive the application forms

$683,060
No
    No
    No
No
No
No
Yes
Sherette Funn-Coleman

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/14/2020


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