Veterinary Medicine Loan Repayment Program Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NIFA-0004 Loan Information	Form	New	Available
Form NIFA-0008 Recommendation Form	Form	New	Available
Form NIFA-0007 Intent of Employment	Form	New	Available
Form NIFA-0006 Certifications for Application	Form	New	Available
Form NIFA-0005 Veterinary Medicine Loan Repayment Program Contract	Form	New	Available
Form NIFA-0003 List of Recommenders	Form	New	Available
Form NIFA-0002 Personal Statement	Form	New	Available
Form NIFA-0001 Applicant Information	Form	New	Available
Memo2.pdf	Supplementary Document	Uploaded 2010-02-01	Available
VMLRP Program Supporting Statement Final.docx	Supporting Statement A	Uploaded 2010-02-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
191733	Veterinary Medicine Loan Repayment Program Application	Form	New	Loan Information
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	Recommendation Form
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	Intent of Employment
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	Certifications for Application
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	Veterinary Medicine Loan Repayment Program Contract
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	List of Recommenders
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	Personal Statement
191731	Veterinary Medicine Loan Repayment Program Application	Form	New	Applicant Information

ICR Details

OMB Control No: 0524-0047	ICR Reference No: 201001-0524-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: USDA/NIFA	Agency Tracking No:
Title: Veterinary Medicine Loan Repayment Program Application
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/12/2010
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/29/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/01/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2010	6 Months From Approved
Responses	600	0	0
Time Burden (Hours)	1,350	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information proposed for collection allows the National Institute of Food and Agriculture (NIFA) to request from VMLRP applicants information related to eligibility, qualifications, career interests, and recommendations necessary to evaluate their applications for repayment of educational indebtedness in return for agreeing to provide veterinary services in veterinarian shortage situations. The information proposed for collection will also be used to determine an applicant’s eligibility for participation in the program.

Emergency Justfication: The National Institute of Food and Agriculture (NIFA) is requesting an emergency clearance for the VMLRP application forms. With the enactment of the Food, Conservation, and Energy Act of 2008, it is the expectation of Congress that NIFA would be able to make its first VMLRP agreements by the end of Fiscal Year 2010. NIFA is requesting emergency clearance in order to collect information from interested applicants from April 1 to June 30, 2010. This timeframe is necessary to allow NIFA to execute its first agreements by September 30, 2010.

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Authorizing Statute(s): US Code: 7 USC 3151A Name of Law: National Agricultural Research, Extension, and Teaching Policy Act of 1997
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 3193	01/20/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Veterinary Medicine Loan Repayment Program Application	NIFA-0004	Loan Information
Veterinary Medicine Loan Repayment Program Application	NIFA-0006, NIFA-0007, NIFA-0002, NIFA-0001, NIFA-0008, NIFA-0003, NIFA-0005	Applicant Information ,   Personal Statement ,   List of Recommenders ,   Veterinary Medicine Loan Repayment Program Contract ,   Certifications for Application ,   Intent of Employment ,   Recommendation Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	600	0	0	600	0	0
Annual Time Burden (Hours)	1,350	0	0	1,350	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection of information.

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Annual Cost to Federal Government: $45,934

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/01/2010

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