OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps

OMB 0937-0025 · HHS/OASH.

OMB 0937-0025

The Commissioned Corps of the U.S. Public Health Service has a need for the information in order to assess the qualifications of each applicant and make a determination whether the applicant meets the requirements to receive a commission. The information is used to make determinations on candidates/applicants seeking appointment to the Regular Corps and Ready Reserve Corps to assess whether they are suitable for life in the uniformed services based upon a review of a variety of assessment factors including, but not limited to: personal adjustment, employment history, character, and a candidate's prior history of service in one of the uniformed services. Their potential for leadership as a commissioned officer and their ability to deal effectively with people is evaluated.

The latest form for Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps expires 2027-02-28 and is listed under ICR 202312-0937-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form PHS-50 PHS-50Form and Instruction
Form PHS-1813 PHS-1813Form
SS-A 0937-0025 PHS 50 and PHS 1813 revised (6).docxSupporting Statement A
2023-27974 60 Day Notice 2023.pdf Supplementary Document
PHS-50 Form and Instruction
PHS-1813 Form
Addendum: Commissioned Corps Personal Statement Other-Personal Statement
Interested Health Professionals Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202312-0937-001 Revision of a currently approved collection 2023-12-29 Approved with change
202008-0937-001 Revision of a currently approved collection 2020-10-14 Approved without change
201911-0937-001 Revision of a currently approved collection 2019-12-27 Approved with change
201607-0937-001 Extension without change of a currently approved collection 2016-09-12 Approved without change
201310-0937-002 Extension without change of a currently approved collection 2013-10-29 Approved without change
201007-0937-001 Reinstatement with change of a previously approved collection 2010-07-02 Approved without change
200612-0937-001 Extension without change of a currently approved collection 2006-12-28 Approved without change
200307-0937-001 Revision of a currently approved collection 2003-07-29 Approved with change
200005-0937-001 Revision of a currently approved collection 2000-05-12 Approved without change
199706-0937-001 Revision of a currently approved collection 1997-06-11 Approved without change
199403-0937-002 Revision of a currently approved collection 1994-03-22 Approved without change
199105-0937-002 No material or nonsubstantive change to a currently approved collection 1991-05-07 Approved with change
199102-0937-001 Revision of a currently approved collection 1991-02-05 Approved without change
198801-0937-004 Revision of a currently approved collection 1988-01-28 Approved without change
198412-0937-005 Revision of a currently approved collection 1984-12-27 Approved without change
198212-0937-001 Revision of a currently approved collection 1982-12-23 Approved without change
197805-0937-001 New collection (Request for a new OMB Control Number) 1978-05-31 Approved without change

OMB Details

PHS-50

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
FormNameElectronic accessType
Form PHS-50APPLICATION FOR APPOINTMENT AS A COMMISSIONED OFFICER IN THE COMMISSIONED CORPS OF THE U.S. PUBLIC HEALTH SERVICEFillable Fileable SignableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.