Health Education Assistance Loan (HEAL) Program Information Collection Requirements - Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0043 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

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IC Title:	Health Education Assistance Loan (HEAL) Program Information Collection Requirements - Forms	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.	Available Electronically?	Can Be Submitted Electronically?
Form	HRSA-502-2	No	No
Form	HRSA-512	No	No
Form	HRSA-502-1	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,088	-6,866	-4,992	23,946
Annual IC Time Burden (Hours)	6,066	-3,439	-2,500	12,005
Annual IC Cost Burden (Dollars)	0	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.