[Federal Register Volume 69, Number 36 (Tuesday, February 24, 2004)]
[Notices]
[Pages 8459-8460]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-3866]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Proposed Information Collection: Request for Public Comment: 60-
Day Notice

AGENCY: Indian Health Service, HHS.

ACTION: Request for public comment: 60-day proposed collection; IHS 
Scholarship Program Application.

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SUMMARY: In compliance with section 3506(c)(2)(A) of the Paperwork 
Reduction Act of 1995, to provide a 60-day advance opportunity for 
public comment on proposed information collection projects, the Indian 
Health Service (IHS) is publishing for comment a summary of a proposed 
information collection to be submitted to the Office of Management and 
Budget (OMB) for review.
    Proposed Collection: Title: 0917-0006, ``IHS Scholarship Program 
Application.'' Type of Information Collection Request: 3-year 
extension, with change, additional forms required for application. Form 
Number(s): IHS-856, 856-2 through 8856-8, IHS-815, IHS-816, IHS-817, 
IHS-818, D-02, F-02, F-04, G-02, G-04, H-07, H-08, J-04, J-05, K-03, K-
04, and L-03. Reporting formats are contained in an IHS Scholarship 
Program application booklet. Need and Use of Information Collection: 
The IHS Scholarship Branch needs this information for program 
administration and uses the information to solicit, process and award 
IHS Pre-graduate, Preparatory and/or Health Professions Scholarship 
grantees and monitor the academic performance of awardees, to place 
awardees at payback sites, and for awardees to request additional 
program. The IHS Scholarship Program is streamlining the application to 
reduce the time needed by applicants to complete and provide the 
information and plans for using information technology to make the 
application electronically available on the internet. Affected Public: 
Individuals, not-for-profit institutions

[[Page 8460]]

and State, local or Tribal Government. Type of Respondents: Students 
pursuing health care professions.
    The table below provides: Types of data collection instruments, 
Estimated number of respondents, Number of responses per respondent, 
Annual number of responses, Average burden hour per response, and Total 
annual burden hour(s).

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                                                     Number of     Responses per    Total annual                                           Annual burden
          Data collection instrument(s)             respondents      respondent       response           Burden hour per response*             hours
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Scholarship Application (IHS-856)...............           1,500               1            1,500  1.00 (60 min)........................           1,500
Checklist (856-2)...............................           1,500               1            1,500  0.13 (8 min).........................             195
Course Verification (856-3).....................           1,500               1            1,500  0.70 (42 min)........................           1,050
Faculty/Employer Application (856-4)............           1,500               2            3,000  0.83 (50 min)........................           2,490
Justification (856-5)...........................           1,500               1            1,500  0.75 (45 min)........................           1,125
Federal Debt (856-6)............................           1,500               1            1,500  0.13 (8 min).........................             195
MPH only (856-7)................................              25               1               25  0.83 (50 min)........................              21
Accept/Decline (856-8)..........................             650               1              650  0.13 (8 min).........................              84
Receipt of Application (815)....................           1,500               1            1,500  0.03 (2 min).........................              45
Address Change Notice (816).....................              25               1               25  0.02 (1 min).........................              25
Scholarship Program Agreement (817).............             850               1              850  0.05 (3 min).........................              43
Stipend Checks (D-02)...........................             100               1              100  0.13 (8 min).........................              13
Enrollment (F-02)...............................           1,300               1            1,300  0.13 (8 min).........................             169
Academic Problem/Change (F-04)..................              50               1               50  0.13 (8 min).........................               6
Request Assistance (G-02).......................             217               1              217  0.13 (8 min).........................              28
Summer School (G-04)............................             193               1              193  0.10 (6 min).........................              19
Health Professions Contract (818)...............             850               1              850  0.05 (3 min).........................              33
Placement (H-07)................................             250               1              250  0.18 (11 min)........................              45
Graduation (H-08)...............................             250               1              250  0.17 (10 min)........................              43
Site Preference (J-04)..........................             150               1              150  0.13 (8 min).........................              20
Travel Reimb (J-05).............................             150               1              150  0.10 (6 min).........................              15
Status Report (K-03)............................             250               1              250  0.25 (15 min)........................              63
Preferred Assignment (K-04).....................             200               1              200  0.75 (45 min)........................             150
Request of Deferment (L-03).....................              20               1               20  0.13 (8 min).........................               3
                                                 -----------------
        Total...................................          15,830  ...............  ..............  .....................................           7,380
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* For ease of understanding, burden hours are also provided in actual minutes.

    There are no Capital Costs, Operating Costs and/or Maintenance 
Costs to report.
    Request for Comments: Your written comments and/or suggestions are 
invited on one or more of the following points: (a) Whether the 
information collection activity is necessary to carry out an agency 
function; (b) whether the agency processes the information collected in 
a useful and timely fashion; (c) the accuracy of public burden estimate 
(the estimated amount of time needed for individual respondents to 
provide the requested information); (d) whether the methodology and 
assumptions used to determine the estimate are logical; (e) ways to 
enhance the quality, utility, and clarity of the information being 
collected; and (f) ways to minimize the public burden through the use 
of automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology.
    Send Comments and Requests For Further Information: Send your 
written comments, requests for more information on the proposed 
collection, or requests to obtain a copy of the data collection 
instrument(s) and instructions to: Ms. Chris Ingersoll, IHS Reports 
Clearance Officer, 12300 Twinbrook Parkway, Suite 450, Rockville, MD 
20852-1610: call non-toll free (301) 443-5938, send via facsimile to 
(301) 443-2316, or send your e-mail requests, comments and return 
address to: [email protected].
    Comment Due Date: Your comments regarding this information 
collection are best assured of having their full effect if received 
within 60 days of the date of this publication.

    Dated: February 17, 2004.
Michel Lincoln,
Deputy Director, Indian Health Service.
[FR Doc. 04-3866 Filed 2-23-04; 8:45 am]
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