Repayment Schedule HRSA-502 1,2

Health Education Assistance Loan (HEAL)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0043 can be found here:

Documents and Forms

Document Name Document Type
Form HRSA 502-2 Repayment Schedule HRSA-502 1,2 Form and Instruction
HRSA 502-2 Repayment Schedule-Fixed Rate HRSA-502-2.doc Form and Instruction
HRSA 502-1 Repayment Schedule-Variable Rate 502-1 HRSA-502-1.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Repayment Schedule HRSA-502 1,2	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HRSA 502-2	Repayment Schedule-Fixed Rate	HRSA-502-2.doc		Yes	Yes	Fillable Fileable
Form and Instruction	HRSA 502-1	Repayment Schedule-Variable Rate 502-1	HRSA-502-1.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-15-0044 Health Educational Assistance Loan Program (HEAL) Loan Control Master File	FR Citation: 61 FR 31143

Number of Respondents: 8	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,168	-2,160	5,328
Annual IC Time Burden (Hours)	1,584	-1,080	2,664
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.