HEAL Lender's Application for Insurance Claim

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

OMB: 1845-0127

IC ID: 185895

Information Collection (IC) Details

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HEAL Lender's Application for Insurance Claim
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 60.40

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NA Form 510 Final of HEAL form 510 6 19 2014.docx Yes No Fillable Fileable
Instruction Instructions for HEAL form 510 July 2014 508 approved.docx Yes No Printable Only

Education Higher Education

Health Education Assistance Loan  79 FR 36299

13 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 364 0 0 0 0 364
Annual IC Time Burden (Hours) 182 0 0 0 0 182
Annual IC Cost Burden (Dollars) 2,548 0 0 0 0 2,548

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