Information Collection

Veterinary Medicine Loan Repayment Program Application

IC 191731 under ICR 201001-0524-001 · OMB 0524-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0524-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NIFA-0001 Veterinary Medicine Loan Repayment Program Application	Form
NIFA-0001 Applicant Information NIFA VMLRP - 01 - Applicant Information.pdf	Form
NIFA-0002 Personal Statement NIFA VMLRP - 02 - Personal Statement.pdf	Form
NIFA-0003 List of Recommenders NIFA VMLRP - 03 - List of Recommenders.pdf	Form
NIFA-0005 Veterinary Medicine Loan Repayment Program Contract NIFA VMLRP - 05 - Contract.pdf	Form
NIFA-0006 Certifications for Application NIFA VMLRP - 06 - Certifications for Application.pdf	Form
NIFA-0007 Intent of Employment NIFA VMLRP - 07 - Intent of Employment.pdf	Form
NIFA-0008 Recommendation Form NIFA VMLRP - 08 - Recommendation Form.pdf	Form

IC Title:

Veterinary Medicine Loan Repayment Program Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 3431

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NIFA-0001	Applicant Information	NIFA VMLRP - 01 - Applicant Information.pdf	Yes	No	Paper Only
Form	NIFA-0002	Personal Statement	NIFA VMLRP - 02 - Personal Statement.pdf	Yes	No	Paper Only
Form	NIFA-0003	List of Recommenders	NIFA VMLRP - 03 - List of Recommenders.pdf	Yes	No	Paper Only
Form	NIFA-0005	Veterinary Medicine Loan Repayment Program Contract	NIFA VMLRP - 05 - Contract.pdf	Yes	No	Paper Only
Form	NIFA-0006	Certifications for Application	NIFA VMLRP - 06 - Certifications for Application.pdf	Yes	No	Paper Only
Form	NIFA-0007	Intent of Employment	NIFA VMLRP - 07 - Intent of Employment.pdf	Yes	No	Paper Only
Form	NIFA-0008	Recommendation Form	NIFA VMLRP - 08 - Recommendation Form.pdf	Yes	No	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	1,300	1,300
Annual IC Cost Burden (Dollars)	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.