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Agency Information Collection Activities: Submission for OMB Review and Approval; Public Comment Request

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In compliance with section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35), the Health Resources and Services Administration (HRSA) will submit an Information Collection Request (ICR) to the Office of Management and Budget (OMB). Comments submitted during the first public review of this ICR will be provided to OMB. OMB will accept further comments from the public during the review and approval period. To request a copy of the clearance requests submitted to OMB for review, email or call the HRSA Reports Clearance Office at 301-443-1984.

Information Collection Request Title: National Health Service Corps Travel Request Worksheet (OMB No. 0915-0278)—Revision

Abstract: Clinicians participating in the HRSA National Health Service Corps (NHSC) Scholarship Program use the online Travel Request Worksheet to request travel funds from the Federal Government to perform pre-employment interviews at sites on the NHSC's Opportunities List. The travel approval process is initiated when a scholar notifies the NHSC of an impending interview at one or more NHSC approved practice sites. The Travel Request Worksheet is also used to initiate the relocation process after a NHSC scholar has successfully been matched to an approved practice site. Upon receipt of the Travel Request Worksheet, the NHSC will review and approve or disapprove the request and promptly notify the scholar and the NHSC logistics contractor regarding travel arrangements and authorization of the funding for the site visit or relocation.

Burden Statement: Burden in this context means the time expended by persons to generate, maintain, retain, disclose or provide the information requested. This includes the time needed to review instructions, to develop, acquire, install and utilize technology and systems for the purpose of collecting, validating and verifying information, processing and maintaining information, and disclosing and providing information, to train personnel and to be able to respond to a collection of information, to search data sources, to complete and review the collection of information, and to transmit or otherwise disclose the information. The total annual burden hours estimated for this Information Collection Request are summarized in the table below.

The annual estimate of burden is as follows:

InstrumentNumber of respondentsResponses per respondentTotal responsesHours per responseTotal burden hours
Scholar Travel Request Worksheet1802360.066724


Submit your comments to the desk officer for HRSA, either by email to or by fax to 202-395-5806. Please direct all correspondence to the “attention of the desk officer for HRSA.”

Deadline: Comments on this ICR should be received within 30 days of this notice.

Dated: December 14, 2012.

Bahar Niakan,

Director, Division of Policy and Information Coordination.

[FR Doc. 2012-30690 Filed 12-19-12; 8:45 am]