OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

NHSC SP – Verification of Vulnerable Background

IC 211160 under ICR 202608-0915-003 · OMB 0915-0146.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 1G
NHSC SP Verification of Vulnerable Background Status Form NHSC SP – Verification of Vulnerable Background		 Form and Instruction
1G NHSC SP Verification of Vulnerable Background Status For
NHSC SP Verification of Vulnerable Background Status Form.docx 		Form and Instruction
NHSC SP Verification of Vulnerable Background Status Form (Redline).pdf
NHSC SP Verification of Vulnerable Background Status Form (Redline 06302026)		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 1G Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 615 0 0 0 0 615
Annual IC Time Burden (Hours) 154 0 0 0 0 154
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
NHSC SP Verification of Vulnerable Background Status Form (Redline 06302026) 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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