# Agency Information Collection Request. 60-Day Public Comment Request
**AGENCY:**
Office of the Secretary, HHS.
**ACTION:**
Notice.
**SUMMARY:**
In compliance with the requirement of the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), Department of Health and Human Services, is publishing the following summary of a proposed collection for public comment.
**DATES:**
Comments on the ICR must be received on or before December 4, 2023.
**ADDRESSES:**
Submit your comments to *[email protected]* or by calling (202) 264-0041 and *[email protected]* .
**FOR FURTHER INFORMATION CONTACT:**
When submitting comments or requesting information, please include the document identifier 0937-0025-60D and project title for reference, to Sherrette A. Funn, email: *[email protected], [email protected]* or call (202) 264-0041 the Reports Clearance Officer.
**SUPPLEMENTARY INFORMATION:**
Interested persons are invited to send comments regarding this burden estimate or any other aspect of this collection of information, including any of the following subjects: (1) The necessity and utility of the proposed information collection for the proper performance of the agency's functions; (2) the accuracy of the estimated burden; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden.
*Title of the Collection:* U.S. Public Health Service Commissioned Corps.
*Type of Collection:* Extension.
*OMB No.* 0937-0025.
*Abstract:* The Commissioned Corps of the U.S. Public Health Service has a need for the information in order to assess the qualifications of each applicant and make a determination whether the applicant meets the requirements to receive a commission. The information is used to make determinations on candidates/applicants seeking appointment to the Regular Corps and Ready Reserve Corps to assess whether they are suitable for life in the uniformed services based upon a review of a variety of assessment factors including, but not limited to: personal adjustment, employment history, character, and a candidate's prior history of service in one of the uniformed services. Their potential for leadership as a commissioned officer and their ability to deal effectively with people is evaluated.
| Type of | Form name | Number of | Number of | Number | Average | Total |
| --- | --- | --- | --- | --- | --- | --- |
| Interested Health Professionals | Prequalification Questionnaire | 6,000 | 1,000 | 1 | 10/60 | 1,167 |
| Health Professionals | Form PHS-50 | 3,000 | 500 | 1 | 15/60 | 875 |
| References (college professors/teachers) | Form PHS-1813 | 3,000 | 500 | 1 | 15/60 | 875 |
| Health Professionals | Addendum: Commissioned Corps Personal Statement | 3,000 | 500 | 1 | 15/60 | 875 |
| | | | | | | 3,792 |
Sherrette A. Funn,
Paperwork Reduction Act Reports Clearance Officer, Office of the Secretary.