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Notification of Impending Graduation
Application for Participation in the IHS Scholarship Program
OMB: 0917-0006
IC ID: 263141
OMB.report
HHS/IHS
OMB 0917-0006
ICR 202310-0917-001
IC 263141
( )
Documents and Forms
Document Name
Document Type
Form IHS-856-13
Notification of Impending Graduation
Form and Instruction
IHS-856-13 Notification of Impending Graduation
Notice of Impending Graduation.pdf
Form and Instruction
IHS-856-13 Notice of Impending Graduation
Notice of Impending Graduation_Final.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Notification of Impending Graduation
Agency IC Tracking Number:
856-13
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
IHS-856-13
Notice of Impending Graduation
Notice of Impending Graduation_Final.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
170
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
170
0
170
0
0
0
Annual IC Time Burden (Hours)
28
0
28
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.