FY2020 NIH Loan Repayment Program Application Information Survey (OD/LRP)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 FY2020 NIH Loan Repayment Program Application Information Survey (OD/LRP) Form and Instruction
1 FY2020 LRP Application Information Survey FY2020 LRP Application Information Survey Screenshots.pdf Form and Instruction
FY2020 LRP Application Information Survey - PCB Fasttrack Template.doc FY 2020 LRP Application Information Survey fast track IC Document
FY2020 LRP Application Information Survey - Invitation Email.docx email invitation IC Document

Information Collection (IC) Details

IC Title:	FY2020 NIH Loan Repayment Program Application Information Survey (OD/LRP)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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	1	FY2020 LRP Application Information Survey	FY2020 LRP Application Information Survey Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FY 2020 LRP Application Information Survey fast track	FY2020 LRP Application Information Survey - PCB Fasttrack Template.doc	01/08/2020
email invitation	FY2020 LRP Application Information Survey - Invitation Email.docx	01/08/2020

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