OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

S2S LRP - Verification of Vulnerable Background

IC 211169 under ICR 202606-0915-003 · OMB 0915-0146.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

S2S LRP - Verification of Vulnerable Background
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3G NHSC S2S LRP Verification of Vulnerable Background Status Form NHSC S2S LRP Verification of Vulnerable Background Status Form.docx Yes Yes Fillable Fileable

Health Health Care Services

Public Health Service National Health Service Corps Scholarship/Loan Repayment Participants Records System  58 FR 12968

115 0
   
Individuals or Households
 
   100 %

  Requested 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 115 0 0 0 0 115
Annual IC Time Burden (Hours) 29 0 0 0 0 29
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
NHSC S2S LRP Verification of Vulnerable Background Status Form (Redline) NHSC S2S LRP Verification of Vulnerable Background Status Form (Redline).pdf 06/30/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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