View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

The National Health Service Corps (NHSC) Loan Repayment Program Application
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 621

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable
Form and Instruction 3 Yes Yes Fillable Fileable
Form 2A Yes Yes Fillable Fileable
Form 3A Yes Yes Fillable Fileable
Form 3B Yes Yes Fillable Fileable

Health Health Care Services

The Public Health Service and National Health Service Corps Health Care Provider Records System  58 FR 12968

8,200 0
   
Individuals or Households
 
   100 %

  Approved 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 8,200 0 0 0 0 8,200
Annual IC Time Burden (Hours) 8,200 0 0 0 0 8,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
FINAL 0127 NON-SUBSTANTIVE CHANGE MEMO 09/05/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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