OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202305-0915-001 · OMB 0915-0146 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 1A NHSC Scholarship Program Application Form and Instruction Modified Repair queued
Form 4H NHHSP Letters of Reccomendation Form and Instruction New Repair queued
Form 4G NHHSP Graduation Documentation Form Form and Instruction Modified Repair queued
Form 4F NHHSP Change in Program Curriculum Form Form and Instruction Modified Repair queued
Form 4E NHHSP Scholar Enrollment Verification Form Form and Instruction Modified Available
Form 4C NHHSP Acceptance/Verification of Good Standing Report Form and Instruction Modified Repair queued
Form 4B NHHSP Authorization to Release Information Form and Instruction Modified Repair queued
Form 4A Native Hawaiian Health Scholarship Program Application Form and Instruction Modified Repair queued
Form 3E S2S LRP - Verification of Disadvantaged Background Form and Instruction Modified Repair queued
Form 3D S2S LRP – Acceptance/Verification of Good Standing Report Form and Instruction Modified Repair queued
Form 3C S2S LRP – Authorization to Release Information Form and Instruction Modified Repair queued
Form 3B-Instructions S2S LRP - Letters of Recommendation Form and Instruction Modified Repair queued
Form 3-1 NHSC Students to Service Repayment Program Application Form and Instruction Modified Repair queued
Form 2E NHSC SP Awardees Schools – Enrollment Verification Form Form and Instruction Modified Repair queued
Form 2D NHSC SP Awardees Schools – Post Graduate Training Verification Form Form and Instruction Modified Repair queued
Form 2C NHSC SP Awardees Schools – Data Collection Worksheet Form and Instruction Modified Repair queued
Form 2B NHSC SP – Verification of Disadvantaged Background Form and Instruction Modified Repair queued
Form 4-2 NHHSP Letters of Recommendation Form and Instruction Removed Repair queued
Form 1D NHSC SP – Acceptance/Verification of Good Standing Report Form and Instruction Modified Missing upstream
Form 1C NHSC SP Authorization to Release Information Form and Instruction Modified Repair queued
Form 1B NHSC SP Letters of Recommendation Form and Instruction Modified Repair queued
Revised BHW Scholarship Programs Supporting Statement.docx Supporting Statement A Uploaded 2023-05-08 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
6375 NHSC Scholarship Program Application Form and Instruction Modified
260078 NHHSP Letters of Reccomendation Form and Instruction New
242296 NHHSP Graduation Documentation Form Form and Instruction Modified
242295 NHHSP Change in Program Curriculum Form Form and Instruction Modified
242294 NHHSP Scholar Enrollment Verification Form Form and Instruction Modified
242293 NHHSP Acceptance/Verification of Good Standing Report Form and Instruction Modified
242292 NHHSP Authorization to Release Information Form and Instruction Modified
211172 Native Hawaiian Health Scholarship Program Application Form and Instruction Modified
211169 S2S LRP - Verification of Disadvantaged Background Form and Instruction Modified
211167 S2S LRP – Acceptance/Verification of Good Standing Report Form and Instruction Modified
211166 S2S LRP – Authorization to Release Information Form and Instruction Modified
211165 S2S LRP - Letters of Recommendation Form and Instruction Modified
211164 NHSC Students to Service Repayment Program Application Form and Instruction Modified
211163 NHSC SP Awardees Schools – Enrollment Verification Form Form and Instruction Modified
211162 NHSC SP Awardees Schools – Post Graduate Training Verification Form Form and Instruction Modified
211161 NHSC SP Awardees Schools – Data Collection Worksheet Form and Instruction Modified
211160 NHSC SP – Verification of Disadvantaged Background Form and Instruction Modified
211159 NHHSP Letters of Recommendation Form and Instruction Removed
211157 NHSC SP – Acceptance/Verification of Good Standing Report Form and Instruction Modified
211155 NHSC SP Authorization to Release Information Form and Instruction Modified
211154 NHSC SP Letters of Recommendation Form and Instruction Modified
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/HSA
OMB Control No0915-0146
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202006-0915-004
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31