Information Collection

Request For Collection Assistance Under The Health Education Assistance Loan (heal) Program

IC 110290 under ICR 199401-0915-002 · OMB 0915-0100.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0100 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	REQUEST FOR COLLECTION ASSISTANCE UNDER THE HEALTH EDUCATION ASSISTANCE LOAN (HEAL) PROGRAM	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HRSA-513				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	17,000	11,000	6,000
Annual IC Time Burden (Hours)	2,833	333	2,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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