Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Authorization to Release Information Form Modified 7100 710 0 Form and Instruction 6 NC LRD Authorization to Release Information Form
Confirmation of Interest Form Modified 500 100 0 Form and Instruction 4 Confirmation of Interest Form
Disadvantaged Background Form Modified 450 90 0 Form and Instruction 5 Disadvantaged Background Form
Employment Verification Form Modified 7100 710 0 Form and Instruction 7 LRP Nurse Faculty Employment Verification Form
NURSE Corps LRP Application Modified 7100 14200 0 Form and Instruction 1 NC LRP - Application Form - Revised.docx
Form and Instruction 8 LRP Application User Guide
Nurse Corps Crtiical Shortage Facility (CSF) Verification Form Modified 500 50 0 Form and Instruction 2 NC LRP Employment Verification Form
Nurse Corps Nurse Faculty Employment Verification Form Modified 450 90 0 Form and Instruction 1 Employment Verification Form Mock-Up
Participant Semi-Annual in Service Verification Form Modified 1000 500 0 Form and Instruction 3 Participant Semi-Annual In Service Verification Form
Total burden requested under this ICR: 24200 16450 0  
To view an IC, click on IC Title