Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
0127 NHSC Authorization to Release Information Form Modified 5175 518 0 Form 0127-4
0127 NHSC Checklist Removed 0 0 0 Form lrp checklist
0127 NHSC Community Site Information Form Modified 5175 3881 0 Form 0127-2
0127 NHSC Lender Removed 0 0 0 Form lrp loan form
0127 NHSC Loan Information and Verification Form Modified 15525 4658 0 Form 0127-3
NHSC Alumni Database New 5000 1000 0 Form 0127-5
NHSC Self-Certification Form New 5175 518 0 Form 0127-6
The National Health Service Corps (NHSC) Loan Repayment Program Modified 5175 1553 0 Form 0127-1
Total burden requested under this ICR: 41225 12128 0  
To view an IC, click on IC Title