Information Collection

Lost Stipend Payment

IC 183625 under ICR 202310-0917-001 · OMB 0917-0006.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form IHS-856-19 Lost Stipend Payment	Form
IHS-856-19 Lost Stipend Payment IHS-856-19 LOST STIPEND PYMT.pdf	Form
IHS-856-19 Lost Stipend Payment IHS-856-19 LOST STIPEND PYMT.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 3506

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	IHS-856-19	Lost Stipend Payment	IHS-856-19 LOST STIPEND PYMT.pdf		No	No	Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: IHS Scholarship Program

FR Citation: 74 FR 50222

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.