UGSP_2007 privacy act notice

NATIONAL INSTITUTES OF HEALTH (NIH) LOAN REPAYMENT AND
SCHOLARSHIP PROGRAMS
PRIVACY ACT NOTICE
The Privacy Act of 1974 (5 USC 552a)
requires that a Federal agency provide the
following notification to each individual
whom it asks to supply information. This
information is contained in the System of
Records of the Department of Health and
Human Services (DHHS) numbered 09-250165, entitled National Institutes of Health
Office of Loan Repayment and Scholarship
(OLRS) Records System, HHS/NIH/OD. An
update of this system of records was published
in the Federal Register on February 8, 2002
(67 Fed. Reg. 6043).
•

The authority for collection of the requested
information is contained in Sections 487A-F
and Section 485G of the PHS Act
(42USC288-1,2,3,4,5,5a,6; and 42USC287c33), and Public Laws 100-607, 101-597,
103-43, 106-310, 106-505, 106-525, and 106554. The Internal Revenue Code at 26 USC
6109 requires the provision of the Social
Security number (SSN) for the receipt of
funds.

•

The principal purposes of information that
you, the applicant or participant, furnish are
(1) to determine your eligibility for loan
repayment or scholarship under Sections
487A-F and Section 485G of the PHS Act,
including verification of the existence and
purpose of your educational loan(s), and
determination of the amount(s) that are
eligible for repayment under the NIH Loan
Repayment and Scholarship Programs
(LRSPs); and (2) to negotiate and verify the
transfer of loan repayments, scholarship
awards, and tax reimbursements to
participants and to the Department of the
Treasury (Treasury), Internal Revenue
Service (IRS).

•

The principal purposes of information that
you, the lender, furnish are (1) to determine
an individual applicant or participant’s
eligibility for loan repayment under Sections
487A-C, E and F, and Section 485G, of the
PHS Act, including verification of the
existence and purpose of an individual’s
educational loan(s), determination of the
amount(s) that are eligible for payment under
the NIH LRSPs; and (2) to negotiate and
verify the transfer of a loan repayment to a
participant’s loan account.

•

The principal purposes of the information
that you, the undergraduate institution,
furnish are (1) to determine an individual
applicant or participant’s eligibility for
scholarship award under Section 487D of the
PHS Act, including verification of the
amounts of tuition and qualifying educational
expenses, including room and board; and (2)
to determine an applicant’s disadvantaged
background status.

•

While disclosure of the information is not
mandatory, you must provide the information
requested to obtain loan repayment and
scholarship benefits authorized by Sections
487A-F and Section 485G of the PHS Act.

•

The information you provide will be made
available to Federal employees responsible
for administering the NIH LRSPs to
determine your eligibility for loan repayment
and scholarship awards, as described above.

•

The information you provide will not be
disclosed without your consent to anyone
outside of DHHS in a manner that identifies
you, except as permitted by the Privacy Act.

Privacy Act Notice

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7. Another Federal agency so that the agency
can effect a salary offset for debts owed by
Federal employees, or so that the agency
can effect an authorized administrative
offset; or to the IRS to request an
individual’s current mailing address to locate
him or her to collect or compromise debt, or
to have a commercial credit report prepared;

16. Officials or representatives of grantee
institutions in connection with the review of a
Loan Repayment Program (LRP) application
or performance or administration under the
terms and conditions of the LRP award; or in
connection with problems that might arise in
performance or administration of the LRP
contract.

8. Another agency that has asked DHHS to
effect a salary or administrative offset to
help collect a debt owed to the United
States;

17. Designated school coordinators to determine
scholarship support, to inform recipients
about their service obligations to NIH, and to
verify service deferments for certain
Undergraduate Scholarship Program
participants; and

9. The IRS to find out whether the applicant
has a delinquent tax account;
10. The IRS to report as taxable income the
written-off portion of a debt owed by an
individual to the Federal Government when a
debt becomes partly or wholly uncollectible;
11. Debt collection agents, other Federal
agencies, and other third parties who are
authorized to collect Federal debts and
information necessary to identify a
delinquent debtor or defaulting participant;

18. DHHS contractors to recruit, screen, and
match health professionals for NIH
employment in qualified research positions;
and to references, medical licensing boards,
and NIH officials to evaluate the applicant’s
professional qualifications, experience, and
suitability.

12. Any third party that may have information
about a delinquent debtor’s or defaulting
participant’s current address;
13. Other Federal agencies that also provide
loan repayment or scholarship at the request
of these Federal agencies in conjunction with
a matching program conducted by these
agencies to detect or curtail fraud and abuse
in Federal loan repayment and scholarship
programs, and to collect delinquent loans or
benefit payments owed to the Federal
Government;
14. The IRS to offset any income tax refunds
that may be due to the individual against the
debt;
15. Other Federal agencies, debt collection
agents, and other third parties who are
authorized to collect a Federal debt to
identify an individual who is delinquent in
loan benefit payments owed to the Federal
Government and the nature of the debt;

Privacy Act Notice

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(See Routine Uses 1-17 for Additional
Disclosures.)
•

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Certifying on NIH 2674-1, “Applicant
Information,” authorizes the disclosure of
information that confirms you are not under
a service obligation, certifying on NIH 26744, “Loan Information,” authorizes the
disclosure of information to the lenders and
their authorized collection agents to confirm
that your loans are current in their
repayment status, and certifying on NIH
2674-10, “Institutional Information,”
authorizes the disclosure of information to
the extramural research institutions and their
authorized officials to confirm that you are
eligible for the loan repayment program and
able to fulfill the two-year service obligation.
Certifying on NIH 2762-1, “Undergraduate
Scholarship Applicant Information,” NIH
2762-2, “Applicant Information:
Recommendation,” and NIH 2762-3,
“Undergraduate Institution Certification,”
authorizes the disclosure of information to
the undergraduate institution to determine
your eligibility for participation in the
Undergraduate Scholarship Program, to
confirm your eligibility for disadvantaged
background status and non-delinquent loan
status, and to disclose your educational
expenses.

Provision of Your Social Security Number
Under Public Law 93-579, Section 7(b), Privacy
Act of 1974
•

Provision of your SSN is required for
participation of the LRSPs. This provision is
required, as provided in the Internal Revenue
Code 26 USC 6109.

•

Provision of your SSN is needed to verify
the financial information provided in your
application. Your SSN will be given to the
Treasury to disburse Federal funds in
connection with the program benefit. Your
SSN will be used for identification with the
records of the Treasury and DHHS in the
event of the loss or theft of repayment
checks or scholarship awards or other

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Privacy Act Notice

difficulties arising from this transaction. Your
SSN will be given to consumer reporting
agencies to obtain a commercial credit report
that verifies your ability to repay debts owed
to the Federal Government.
•

Your SSN will be disclosed to the IRS when
making loan repayments or scholarship
awards and tax reimbursement payments to
the IRS for the benefits you receive under
the LRSPs. Your SSN will be disclosed to
the IRS to obtain a current mailing address if
you default on your service obligation, and to
other Federal agencies, commercial credit
bureaus, or collection agencies to offset or
collect delinquent debts.

Routine Uses as Permitted by the Privacy Act
Disclosure of information may be made to:
1. A Congressional office in response to a
written request by the applicant or
participant concerning his or her record;
2. The Department of Justice or to a court in
the event of litigation;
3. The appropriate agency, whether Federal,
foreign, State, local, or tribal, in the event
that a system of records indicates a violation
or potential violation of law;
4. DHHS contractors for the purpose of
processing or refining records, and/or for the
purpose of evaluating the programs covered
by the system;
5. Private parties such as present and former
employers, references listed on application
and associated forms, other references, and
educational institutions to determine if an
applicant is suitable for participation in the
NIH LRSPs;
6. A consumer reporting agency (credit bureau)
to obtain a commercial credit report to
establish an individual’s creditworthiness; to
assess and verify his or her ability to repay
debts owed to the Federal Government; and
to determine and verify the eligibility of loans
submitted for repayment;