Form 3 Authorization for Disclosure of Loan Information

The National Health Service Corps (NHSC) Loan Repayment Programs

Authorization for Disclosure of Loan Information Form

Authorization for Disclosure of Loan Information Form

OMB: 0915-0127

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0915-0127 can be found here:

2024-04-11 - Revision of a currently approved collection

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