NHSC SP – Verification of Disadvantaged Background

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: 211160

Information Collection (IC) Details

View Information Collection (IC)

NHSC SP – Verification of Disadvantaged Background
 
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
Form and Instruction 2B Verification of Disadvantaged Background Status Verification of Disadvantaged Background Status.docx Yes Yes Fillable Fileable

Health Health Care Services

 

615 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 615 0 68 0 0 547
Annual IC Time Burden (Hours) 154 0 17 0 0 137
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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