Information Collection

Repayment Schedule HRSA-502 1,2

IC 45766 under ICR 200610-0915-002 · OMB 0915-0043.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HRSA-502-2 Repayment Schedule HRSA-502 1,2	Form and Instruction
HRSA-502-2 Repayment Schedule- Fixed Rate REPAYMENT SCHEDULE FIXED.doc	Form and Instruction
HRSA-502-1 Repyament Schedule- Variable Rate REPAYMENT SCHEDULE variable.doc	Form and Instruction

IC Title:

Repayment Schedule HRSA-502 1,2

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HRSA-502-2	Repayment Schedule- Fixed Rate	REPAYMENT SCHEDULE FIXED.doc		Yes	Yes	Fillable Fileable
Form and Instruction	HRSA-502-1	Repyament Schedule- Variable Rate	REPAYMENT SCHEDULE variable.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction:

Privacy Act System of Records

Title: 09-15-0044 Health Educational Assistance Loan Program (HEAL) Loan Control Master File

FR Citation: 61 FR 31143

Number of Respondents: 8

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	5,328	10,070	-4,742
Annual IC Time Burden (Hours)	2,664	5,055	-2,391
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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