LENDER'S APPLICATION FOR CONTRACT OF FEDERAL LOAN INSURANCE (HEAL)

ICR 198401-0915-005

OMB: 0915-0037

Federal Form Document

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Status
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ICR Details
0915-0037 198401-0915-005
Historical Active 198204-0915-006
HHS/HSA
LENDER'S APPLICATION FOR CONTRACT OF FEDERAL LOAN INSURANCE (HEAL)
Revision of a currently approved collection   No
Regular
Approved without change 03/02/1984
Retrieve Notice of Action (NOA) 01/27/1984
  Inventory as of this Action Requested Previously Approved
02/28/1987 02/28/1987 01/31/1984
30 0 20
10 0 10
0 0 0

THE PUBLIC HEALTH SERVICE, UNDER A CONTRACT OF INSURANCE, INSURES HEAL LOANS MADE BY LENDERS. A LENDER MUST COMPLETE THE APPLICATION IN ORDE TO BECOME A HEAL PROGRAM LENDER. PHS DETERMINES WHETHER TO ISSUE A CONTRACT OF INSURANCE BASED ON THE INFORMATION IN THE APPLICATION.

None
None


No

1
IC Title Form No. Form Name
LENDER'S APPLICATION FOR CONTRACT OF FEDERAL LOAN INSURANCE (HEAL) HRSA 504

  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 30 20 0 10 0 0
Annual Time Burden (Hours) 10 10 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
01/27/1984


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