Information Collection Request
The NHSC and NURSE Corps Interest Capture Form
ICR 202305-0915-002 · OMB 0915-0337 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0915-0337 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 1 NHSC and NURSE Corps Interest Capture Form |
Form | Modified | Repair queued |
 NHSC-NC Interest Capture Form Supporting Statement - Final.docx |
Supporting Statement A | Uploaded 2023-05-24 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 195587 |  NHSC and NURSE Corps Interest Capture Form |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/HSA |
| OMB Control No | 0915-0337 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202004-0915-006 |
| Agency Tracking No | 21466 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |