Nursing Education Loan Repayment Program -- 42 CFR 57.312(a)

ICR 199711-0915-003

OMB: 0915-0140

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0915-0140 199711-0915-003
Historical Active 199409-0915-002
HHS/HSA
Nursing Education Loan Repayment Program -- 42 CFR 57.312(a)
Revision of a currently approved collection   No
Regular
Approved without change 12/23/1997
Retrieve Notice of Action (NOA) 11/12/1997
  Inventory as of this Action Requested Previously Approved
12/31/2000 12/31/2000 12/31/1997
2,250 0 1,400
2,213 0 1,100
5,000 0 0

Approval is requested for the application form for the Nursing Education Loan Repayment Program. The application requests information on the applicant, including education and current employment site, and on education loans that may be eligible for repayment under the program.

None
None


No

1
IC Title Form No. Form Name
Nursing Education Loan Repayment Program -- 42 CFR 57.312(a)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,250 1,400 0 -66 916 0
Annual Time Burden (Hours) 2,213 1,100 0 -87 1,200 0
Annual Cost Burden (Dollars) 5,000 0 0 0 5,000 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/12/1997


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