Faculty Loan Repayment Program Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0150 can be found here:

Documents and Forms

Document Name Document Type
Form 0915-0150 Faculty Loan Repayment Program Application Form
0915-0150 FLRP 0150 application.doc Form
0150 certification.doc certification IC Document
0150 contract.doc contract IC Document
0150 employment.doc employment IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Faculty Loan Repayment Program Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0915-0150	FLRP	0150 application.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	160	66	94
Annual IC Time Burden (Hours)	160	66	94
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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