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Federal forms, ICRs, and supporting documents

Information Collection

Application for Deemed Health Center Program Recipients to Sponsor Volunteer Health Professionals (VHPs) for Deemed PHS Employment with Liability Protections Under the FTCA

IC 266941 under ICR 202512-0906-001 · OMB 0906-0090.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 2
Application for Deemed Health Center Program Recipients to Sponsor Volunteer Health Professionals (VHPs) for Deemed PHS Employment with Liability Protections Under the FTCA		 Form and Instruction
Form 2
Application for Deemed Health Center Program Recipients to Sponsor Volunteer Health Professionals (VHPs) for Deemed PHS Employment with Liability Protections Under the FTCA Application for Deemed Health Center Program Recipients to Sponsor Volunteer Health Professionals (VHPs) for Deemed PHS Employment with Liability Protections Under the FTCA		 Form and Instruction
2 Application for Deemed Health Center Program Recipients
Clean_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090.docx 		Form and Instruction
2 Application for Deemed Health Center Program Recipients
Clean_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090.docx 		Form and Instruction
Redline_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090.pdf
Redline_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090		IC Document
Redline_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090.pdf
Redline_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 2 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 3,468 0 0 0 0 3,468
Annual IC Time Burden (Hours) 6,936 0 0 0 0 6,936
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Redline_ FTCA Application for Deemed Health Center Program Recipients to Sponsor VHPs Tool 0906-0090 12/10/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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