NHSC and NURSE Corps Interest Capture Form

The NHSC and NURSE Corps Interest Capture Form

OMB: 0915-0337

IC ID: 195587

Information Collection (IC) Details

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NHSC and NURSE Corps Interest Capture Form
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 NHSC NC Interest Capture Form NHSC-NC Interest Capture Form.docx Yes Yes Fillable Fileable

Health Health Care Services


16,144 0
Individuals or Households
   0 %

  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 16,144 0 13,744 0 0 2,400
Annual IC Time Burden (Hours) 404 0 344 0 0 60
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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