Information Collection

HRSA 512- Holder's/Call Report

IC 6327 under ICR 200912-0915-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 512 HRSA 512- Holder's/Call Report	Form and Instruction
HRSA 512 Holder's Report on HEAL HRSA-512.doc	Form and Instruction

IC Title:

HRSA 512- Holder's/Call Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 512	Holder's Report on HEAL	HRSA-512.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

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: 13

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	52	-28	80
Annual IC Time Burden (Hours)	39	-21	60
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.