Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Authorization to Release Information Form New 7100 710 0 Form and Instruction 2 NC LRP Authorization to Release Information - Revised.docx
Confirmation of Interest Form New 500 100 0 Form and Instruction 5-1 NC LRP COI 1-Accept or Decline Award Page - Revised.docx
Form and Instruction 5-2 NC LRP COI 2-Electronic Withholding Allowance Certificate Page - Revised.docx
Form and Instruction 5-3 NC LRP COI 3-Sign your Electronic Contract Page - Revised.docx
Form and Instruction 5-4 NC LRP COI 4-Submitted Landing Page - Revised.docx
Disadvantaged Background Form New 450 90 0 Form and Instruction 4 NC LRP - DAB Form - Revised.docx
Employment Verification Form Modified 7100 710 0 Form and Instruction 3 NC LRP - EVF Form - Revised 3.pdf
NURSE Corps LRP Application Modified 7100 14200 0 Form and Instruction 1 NC LRP - Application Form - Revised.docx
Nurse Corps Crtiical Shortage Facility (CSF) Verification Form New 500 50 0 Form and Instruction 7 NC LRP CSF Employment Verification Form - Revised.docx
Nurse Corps Nurse Faculty Employment Verification Form New 450 90 0 Form and Instruction 8 NC LRP Nurse Faculty Employment Verification Form - Revised.docx
Participant Semi-Annual in Service Verification Form New 1000 500 0 Form and Instruction 6 NCLRP & NF ISV & EV Screenshots - Revised.pptx
Total burden requested under this ICR: 24200 16450 0  
To view an IC, click on IC Title