Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form

ICR 201406-1845-018

OMB: 1845-0127

Federal Form Document

ICR Details
1845-0127 201406-1845-018
Historical Active 201406-1845-004
ED/FSA 2040
Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/25/2014
Retrieve Notice of Action (NOA) 06/24/2014
  Inventory as of this Action Requested Previously Approved
10/31/2014 10/31/2014 10/31/2014
6,149 0 6,149
1,165 0 1,165
2,594 0 2,594

The HEAL Lender's Application for Insurance Claim and the Request for Collection Assistance forms are used in the administration of the Health Education Assistant Loan (HEAL) program. The HEAL program provided federally insured loans to students in certain health professions discliplines, and these forms are used in the administration of the HEAL program. The Lender's Application for Insurance Claim is used by the lending institution to request payment of a claim by the Federal Government. The Request for Collection Assistance form is used by the lender to request pre-claim assistance from the Department of Health and Human Services. Section 525 of the Consolidated Appropriations Act, 2014 transferred the collection of the Health Education Assistance Loan (HEAL) program loans from the US Department of Health and Human Services (HHS) to the US Department of Education (ED). To fulfill this mandate, ED requested and received the transfer of the currently approved forms to a new collection under Federal Student Aid OMB Control Number prefix 1845. The changes to the approved forms will be to identify ED as the agency owner of the HEAL loans, identify new contact information, and minor spelling corrections.

PL: Pub.L. 105 - 392 101 Name of Law: Health Professions Education and Financial Assistance Programs
   PL: Pub.L. 102 - 408 101 Name of Law: Health Professions Education Amendments of 1992
  
None

Not associated with rulemaking

  76 FR 30948 05/27/2011
76 FR 51042 08/17/2011
No

  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 6,149 6,149 0 0 0 0
Annual Time Burden (Hours) 1,165 1,165 0 0 0 0
Annual Cost Burden (Dollars) 2,594 2,594 0 0 0 0
No
No

$15,288
No
No
No
No
No
Uncollected
Beth Grebeldinger 202 708-8242

  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.
06/24/2014


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