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NHHSP Letters of Reccomendation
The National Health Service Corps Scholarship Program, Students to Service Loan Repayment Program, and the Native Hawaiian Health Scholarship Program
OMB: 0915-0146
IC ID: 260078
OMB.report
HHS/HSA
OMB 0915-0146
ICR 202512-0915-003
IC 260078
( )
Documents and Forms
Document Name
Document Type
Form 4G
NHHSP Letters of Reccomendation
Form and Instruction
4G NHHSP Letters of Reccomendation
0915 0146 - NHHSP Letters of Rec.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NHHSP Letters of Reccomendation
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
48 CFR 62.6
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
4G
NHHSP Letters of Reccomendation
0915 0146 - NHHSP Letters of Rec.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Public Health Service National Health Service Corps Scholarship/Loan Repayment Participants Records System
FR Citation:
58 FR 12968
Number of Respondents:
400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
400
0
-220
0
0
620
Annual IC Time Burden (Hours)
100
0
-55
0
0
155
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.