PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Annual Status Report
Modified
200
50
0
Form and Instruction
IHS-856-16
Annual Status Report
Change of Name or Address
Modified
20
3
0
Form and Instruction
IHS-856-22
Change of Name or Address
Change of Status
Modified
50
21
0
Form and Instruction
IHS-856-10
Change of Status
Health Professions Contract
Modified
225
38
0
Form
IHS 818
Contract
IHS Scholarship Program Application
Unchanged
850
850
0
Other-Web Site Apps
Lost Stipend Payment
Removed
0
0
0
Form
IHS-856-19
Lost Stipend Payment
Notice of Impending Graduation
Removed
0
0
0
Form
IHS-856-13
Notice of Impending Graduation
Notification of Academic Problem
Modified
20
3
0
Form and Instruction
IHS-856-9
Notification of Academic Problem
Notification of Deferment Program
Modified
60
8
0
Form and Instruction
IHS-856-14
Notification of Deferment Intent
Notification of Impending Graduation
New
170
28
0
Form and Instruction
IHS-856-13
Notice of Impending Graduation
Placement Update
Modified
170
31
0
Form and Instruction
IHS-856-15
Placement Update
Preferred Placement
Modified
150
75
0
Form and Instruction
IHS-856-12
Preferred Placement
Progress Report - Recipient's Initial Report
Modified
800
107
0
Form and Instruction
IHS-856-8
Progress Report
Request for Approval of Deferment
Modified
60
8
0
Form and Instruction
IHS-856-11
Deferment Approval Request
Request for Credit Validation
Removed
0
0
0
Form
IHS-856-23
Request for Credit Validation
Scholarship Program Agreement
Modified
60
10
0
Form
IHS-817
Scholarship Program Agreement
Summer School Request
Modified
100
10
0
Form and Instruction
IHS-856-21
Summer School Request
Verification of Acceptance or Decline of Award
Modified
300
40
0
Form and Instruction
IHS-856-7
Verification of Acceptance or Decline of Award
Total burden requested under this ICR:
3235
1282
0
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