[Federal Register Volume 75, Number 248 (Tuesday, December 28, 2010)]
[Notices]
[Pages 81623-81624]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-32562]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
Periodically, the Health Resources and Services Administration
(HRSA)
[[Page 81624]]
publishes abstracts of information collection requests under review by
the Office of Management and Budget (OMB), in compliance with the
Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). To request a
copy of the clearance requests submitted to OMB for review, e-mail
[email protected] or call the HRSA Reports Clearance Office on (301)
443-1129.
The following request has been submitted to the Office of
Management and Budget for review under the Paperwork Reduction Act of
1995:
Proposed Project: The National Health Service Corps (NHSC) Scholarship
Program Application (OMB No. 0915-0146)--[Revision]
The National Health Service Corps (NHSC) Scholarship Program
provides the NHSC with the health professionals it requires to carry
out its mission of providing primary health care to populations
residing in areas of greatest need. Under this program, health
professions students are awarded scholarships in return for service in
a federally designated Health Professional Shortage Area (HPSA).
Students are supported who are well qualified to participate in the
NHSC Scholarship Program and who want to assist the NHSC in its
mission, both during and after their period of obligated service. The
NHSC Scholarship Program forms are used to collect relevant information
necessary to make award determinations. Scholars are selected for these
competitive awards based on the information provided in the
application, forms, and supporting documentation. Awards are made to
applicants who demonstrate a high potential for providing quality
primary health care services in HPSAs. The program forms include the
following: The NHSC Scholarship Program Application, Academic and Non-
Academic Evaluation Letters (formerly Letters of Recommendation), the
Authorization to Release Information, the Verification of Acceptance/
Good Standing Report, the Receipt of Exceptional Financial Need
Scholarship, the Verification Regarding Disadvantaged Background and
the Acceptance/Declination Form. Also included are the Data Collection
Worksheet, which is completed by the schools of program participants,
the Deferment Request Form, which is completed by program participants
and the Six-Month Service Obligation Verification Form, which is
completed by program participants and their sites.
The annual estimate of burden for applicants is as follows:
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Number of Responses/ Total Hours per Total burden
Instrument respondents respondent responses response hours
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NHSC Scholarship Program 1,800 1 1,800 2.0 3,600
Application....................
Evaluation Letters.............. 1,800 2 3,600 .50 1,800
Authorization to Release 1,800 1 1,800 .10 180
Information....................
Verification of Acceptance/Good 1,800 1 1,800 .25 450
Standing Report................
Receipt of Exceptional Financial 100 1 100 .25 25
Need Scholarship...............
Verification Regarding 300 1 300 .25 75
Disadvantaged Background.......
Acceptance/Declination Form..... 250 1 250 .10 25
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Total....................... .............. .............. 9,400 .............. 6,155
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The annual estimate of burden for participants/schools/sites is as
follows:
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Number of Responses/ Total Hours per Total burden
Instrument respondents respondent responses response hours
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Data Collection Worksheet....... 400 1 400 1.0 400
Deferment Request Form.......... 60 1 60 .25 15
Six-Month Service Obligation 700 2 1,400 .50 700
Verification Form..............
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Total....................... .............. .............. 1,860 .............. 1,115
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Written comments and recommendations concerning the proposed
information collection should be sent within 30 days of this notice to
the OMB desk officer for HRSA, either by e-mail to [email protected] or by fax to 202-395-6974. Please direct all
correspondence to the ``attention of the OMB desk officer for HRSA.''
Dated: December 21, 2010.
Robert Hendricks,
Director, Division of Policy and Information Coordination.
[FR Doc. 2010-32562 Filed 12-27-10; 8:45 am]
BILLING CODE 4165-15-P