Information Collection

NHSC Spanish Language Assessment Proficiency Test Form

IC 266757 under ICR 202404-0915-002 · OMB 0915-0127.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0127 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8 NHSC Spanish Language Assessment Proficiency Test Form	Form and Instruction
Form 8 NHSC Spanish Language Assessment Proficiency Test Form NHSC Spanish Language Assessment Proficiency Test Form	Form and Instruction
8 NHSC Spanish Language Assessment Proficiency Test Form Spanish Language Proficiency Test Form.docx	Form and Instruction
8 NHSC Spanish Language Assessment Proficiency Test Form Spanish Language Proficiency Test Form.docx	Form and Instruction

IC Title:

NHSC Spanish Language Assessment Proficiency Test Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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 and Instruction	8				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: The Public Health Service and National Health Service Corps Health Care Provider Records System

FR Citation: 86 FR 28362

Number of Respondents: 3,006

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,006	3,006
Annual IC Time Burden (Hours)	1,503	1,503
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].