NHHSP Scholar Enrollment Verification Form

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: 242294

Information Collection (IC) Details

View Information Collection (IC)

NHHSP Scholar Enrollment Verification Form
 
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 4E NHHSP Scholar Enroll Verification Form NHHSP Scholar Enroll Verification Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

40 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 300 0 75 0 0 225
Annual IC Time Burden (Hours) 150 0 37 0 0 113
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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