Veterinary Medicine Loan Repayment Program Application

ICR 201105-0524-001

OMB: 0524-0047

Federal Form Document

IC Document Collections
ICR Details
0524-0047 201105-0524-001
Historical Active 201011-0524-001
USDA/NIFA
Veterinary Medicine Loan Repayment Program Application
Revision of a currently approved collection   No
Regular
Approved with change 10/12/2011
Retrieve Notice of Action (NOA) 05/27/2011
  Inventory as of this Action Requested Previously Approved
10/31/2014 36 Months From Approved 10/31/2011
2,600 0 600
2,820 0 1,350
0 0 0

The information collection allows the National Institute of Food and Agriculture (NIFA) to request from Veterinary Medicine Loan Repayment Program applicants information related to eligibility, qualifications, career interests, and recommendations necessary to evaluate their applications for repayment of educational indebtedness in return for agreeing to provide veterinary services in veterinarian shortage situations.

US Code: 7 USC 3151A Name of Law: National Agricultural Research, Extension, and Teaching Policy Act of 1997
  
None

Not associated with rulemaking

  75 FR 3193 01/20/2010
75 FR 187 09/28/2010
No

2
IC Title Form No. Form Name
Veterinary Medicine Loan Repayment Program Application NIFA-01-10, NIFA-08-10, NIFA-03-10, NIFA-05-10, NIFA-06-10, NIFA-07-10, NIFA-02-10, NIFA-09-10, NIFA-0004 Applicant Information ,   Personal Statement ,   List of Recommenders ,   Veterinary Medicine Loan Repayment Program Contract ,   Certifications for Application ,   Intent of Employment ,   Recommendation Form ,   Service Verification ,   Loan Information
Veterinary Medicine Loan Repayment Program Application NIFA-0004 Loan Information

  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 2,600 600 0 240 1,760 0
Annual Time Burden (Hours) 2,820 1,350 0 60 1,410 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
There is an adjustment increase in the number of respondents, responses and burden hours. The number of applications increased from 100 to 200. The adjustment increase is due to the estimate for applications that were made prior to the inaugural application cycle when there was no base to project the number of applications. The is a program change increase in the number of respondents, responses, and burden of 60 hours due to adding the Service Verification form for award recipients.

$91,868
No
No
No
No
No
Uncollected
Gidel Mendez 202 401-2655 gmendez@nifa.usda.gov

  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.
05/27/2011


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