National Institutes of Health Loan Repayment Programs

Forms and Documents

Document Name	Status
Form 1 Intramural/InitialApplications Form	Modified
Form 1 Extramural/ Recommenders Form	Modified
2674-1 Applicant Informaiton with NIH Commons OMB.pdf Supplementary Document	2012-11-07
OMB Memorandum.doc Justification for No Material/Nonsubstantive Change	2012-11-07

IC Document Collections

IC ID	Document Title	Status
7282	Intramural/InitialApplications Form	Modified
184374	Extramural/ Recommenders Form	Modified
184373	Extramural/ Advisors and Supervisors Instruction	Modified
184372	Extramural/ Renewal Applicants Instruction	Modified
184371	Intramural/ Advisors and Supervisors Instruction	Modified
184370	Intramural/ Renewal Applications Instruction	Modified
184369	Extramural/ Financial Institutions Instruction	Modified
184368	Extramural/ Recommenders Instruction	Modified
184367	Extramural/ Advisors and Supervisors Instruction	Modified
184366	Extramural/ Initial Applicants Instruction	Modified
184365	Intramural/ Financial Institutions Instruction	Modified
184364	Intramural/Recommenders Instruction	Modified
184363	Intramural/Advisors and Supervisors Instruction	Modified

ICR Details

OMB Control No: 0925-0361	ICR Reference No: 201211-0925-002
Status: Historical Active	Previous ICR Reference No: 201104-0925-003
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: National Institutes of Health Loan Repayment Programs
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/09/2012
	Date Received in OIRA: 11/09/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2014	06/30/2014	06/30/2014
Responses	16,090	0	16,090
Time Burden (Hours)	41,664	0	41,664
Cost Burden (Dollars)	0	0	0

---

Abstract: The Loan Repayment Programs are designed to provide repayment of existing eligible loans of up to $35,000 per year to qualified health professionals performing research in fields required by the NIH to support its mission. Approximately 1,675 new applicants and 800 renewal applicants are expected to submit application packages.

---

Authorizing Statute(s): US Code: 42 USC 288-1 Name of Law: AIDS Research loan Repayment Program
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 13

IC Title	Form No.	Form Name
Extramural/ Financial Institutions	1	Application
Intramural/ Renewal Applications	1	Application
Intramural/ Advisors and Supervisors	1	Application
Extramural/ Renewal Applicants	1	Application
Extramural/ Advisors and Supervisors	1	Application
Extramural/ Recommenders	1	Application
Intramural/InitialApplications	1	Application
Intramural/Advisors and Supervisors	1	Application
Intramural/Recommenders	1	Application
Intramural/ Financial Institutions	1	Application
Extramural/ Initial Applicants	1, 1	Survey ,   Application
Extramural/ Advisors and Supervisors	1	Application
Extramural/ Recommenders	1	Application

---

ICR Summary of Burden

	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	16,090	16,090	0	0	0	0
Annual Time Burden (Hours)	41,664	41,664	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $1,448,100

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 11/09/2012

---