View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0915-0301
ICR Reference No:
202303-0915-003
Status:
Active
Previous ICR Reference No:
202003-0915-001
Agency/Subagency:
HHS/HSA
Agency Tracking No:
Title:
The Nursing Scholarship Program
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
05/16/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/11/2023
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2026
36 Months From Approved
05/31/2023
Responses
8,750
0
8,950
Time Burden (Hours)
7,099
0
7,139
Cost Burden (Dollars)
0
0
0
Abstract:
The NCSP collects information to determine an applicant’s eligibility for the program, monitor a participant’s continued enrollment in a school of nursing, monitor the participant’s compliance with the NCSP service obligation, and prepare annual reports to Congress.
Authorizing Statute(s):
US Code:
42 USC 297n(a), section 846(d)
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR 74428
12/05/2022
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 16454
03/17/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
9
IC Title
Form No.
Form Name
Authorization to Release Information Form
10
Authorization To Release Information
CSF Verification Form
9
CSF Verification Form.pdf
Confirmation of Interest Form
3
Confirmation of Interest Form
Data Collection Worksheet Form
4
Data Collection Worksheet Form
Eligible Applications/Application Program Guidance
1
Eligible Applications/Application Program Guidance
Graduation Close Out Form
5
Graduation Close Out Form
In Service Verification Form
7
In Service Verification Form
NC SP Employment Verification Form
6
NC SP Employment Verification Form
School Enrollment Verification Form
2
School Enrollment Verification Form
Verification of Acceptance Form
8
Verification of Acceptance Form
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
8,750
8,950
0
0
-200
0
Annual Time Burden (Hours)
7,099
7,139
0
0
-40
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The total burden hour request has been changed from 6934 to 7099 hours as a result of the inclusion of two new forms that were not previously included in the 60 day FRN, which are needed to effectively monitor participant service and to determine eligibility of participants to continue to receive scholarship benefits and the amount of those benefits.
Annual Cost to Federal Government:
$2,799,704
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Tierra Moore 301 443-0496 tmoore@hrsa.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
04/11/2023
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