Addendum: Commissioned Corps Personal Statement

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

OMB: 0937-0025

IC ID: 223158

Documents and Forms
Document Name
Document Type
Other-personal statement
Information Collection (IC) Details

View Information Collection (IC)

Addendum: Commissioned Corps Personal Statement
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-personal statement 0937-0025 PHS_PersonalStatement_12-22-16.docx Yes Yes Fillable Fileable

Health Health Care Services

 

3,500 0
   
Individuals or Households
 
   0 %

  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 3,500 0 500 0 0 3,000
Annual IC Time Burden (Hours) 875 0 125 0 0 750
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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