Information Collection

NURSE Corps LRP Application

IC 6368 under ICR 202212-0915-001 · OMB 0915-0140.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0140 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NURSE Corps LRP Application	Form and Instruction
Form 1 NURSE Corps LRP Application	Form and Instruction
1 NC LRP - Application Form - Revised.docx NC LRP - Application Form - Revised.docx	Form and Instruction
1 NC LRP - Application Form - Revised.docx NC LRP - Application Form - Revised.docx	Form and Instruction
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf APPLICATION INSTRUCTIONS nelrp-online-application-user-guide	IC Document
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf APPLICATION INSTRUCTIONS nelrp-online-application-user-guide	IC Document

IC Title:

NURSE Corps LRP Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 1320.5(d)(2) 31 CFR 208, 210 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	1	NC LRP - Application Form - Revised.docx	NC LRP - Application Form - Revised.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Public Health Service and National Health Service Corps Scholarship/Loan Repayment Participants Records System

FR Citation: 58 FR 12968

Number of Respondents: 7,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	7,100	7,100
Annual IC Time Burden (Hours)	14,200	14,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide	APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf	02/04/2020

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