View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0906-0073	ICR Reference No: 202607-0906-001
Status: Active	Previous ICR Reference No: 202508-0906-003
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Scholarships for Disadvantaged Students Program Specific Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/09/2026
	Date Received in OIRA: 07/01/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2029	01/31/2029	01/31/2029
Responses	500	0	340
Time Burden (Hours)	7,000	0	4,760
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	500	340	160
Annual Time Burden (Hours)	7,000	4,760	2,240
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Initial Approved Package: HRSA will move the BHW Program Specific Data Form to another ICR that reports data outcomes post grant award. As for average burden per response for the SDS Program Specific Form, SDS program staff conducted burden testing performed by eight grantees regarding the format, content of data to be collected, and time to complete the application and report. The SDS Program Specific Form was reduced from sixteen sections to seven sections. The program staff calculated the time for completion of the revised form at 14 hours based upon program experience and past grant recipient comments. Non-Substantive Change Request: During OMB review, HRSA updated the total number of respondents in the Supporting Statement A to reflect updated totals from the FY 2025 application cycle (the previous numbers reflected the FY 2020 application cycle). The purpose of this request is to make the same change in the burden table in ROCIS.

Annual Cost to Federal Government: $189,323

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: Laura Cooper 301 443-2126 lcooper@hrsa.gov

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