Information Collection

Veterinary Medicine Loan Repayment Program Application

IC 191731 under ICR 201004-0524-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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-01-10 Applicant Information Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-02-10 Personal Statement Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-03-10 List of Recommenders Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-05-10 Veterinary Medicine Loan Repayment Program Contract Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-06-10 Certifications for Application Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-07-10 Intent of Employment Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-08-10 Recommendation Form Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-09-10 Service Verification Veterinary Medicine Loan Repayment Program Application	Form
Form NIFA-0004 Loan Information Veterinary Medicine Loan Repayment Program Application	Form
NIFA-01-10 Applicant Information VMLRP - NIFA-01-10 - Applicant Information 09-14-10 DRAFT.pdf	Form
NIFA-02-10 Personal Statement VMLRP - NIFA-02-10 - Personal Statement 09-14-10 DRAFT.pdf	Form
NIFA-03-10 List of Recommenders VMLRP - NIFA-03-10 - List of Recommenders 09-08-10 DRAFT.pdf	Form
NIFA-05-10 Veterinary Medicine Loan Repayment Program Contract VMLRP - NIFA-05-10 - Contract 09-14-10 DRAFT.pdf	Form
NIFA-06-10 Certifications for Application VMLRP - NIFA-06-10 - Certifications for Application 09-14-10 DRAFT.pdf	Form
NIFA-07-10 Intent of Employment VMLRP - NIFA-07-10 - Intent of Employment 09-13-10 DRAFT.pdf	Form
NIFA-08-10 Recommendation Form VMLRP - NIFA-08-10 - Recommendation Form 09-14-10 DRAFT.pdf	Form
NIFA-09-10 Service Verification VMLRP - NIFA-09-10 - Service Verification.pdf	Form
NIFA-0004 Loan Information VMLRP_-_NIFA-04-10_-_Loan_Information_Form_09-11-10_DRAFT[1].pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Veterinary Medicine Loan Repayment Program Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-01-10	Applicant Information	VMLRP - NIFA-01-10 - Applicant Information 09-14-10 DRAFT.pdf	No		Paper Only
Form	NIFA-02-10	Personal Statement	VMLRP - NIFA-02-10 - Personal Statement 09-14-10 DRAFT.pdf	No		Paper Only
Form	NIFA-03-10	List of Recommenders	VMLRP - NIFA-03-10 - List of Recommenders 09-08-10 DRAFT.pdf	No		Paper Only
Form	NIFA-05-10	Veterinary Medicine Loan Repayment Program Contract	VMLRP - NIFA-05-10 - Contract 09-14-10 DRAFT.pdf	No		Paper Only
Form	NIFA-06-10	Certifications for Application	VMLRP - NIFA-06-10 - Certifications for Application 09-14-10 DRAFT.pdf	No		Paper Only
Form	NIFA-07-10	Intent of Employment	VMLRP - NIFA-07-10 - Intent of Employment 09-13-10 DRAFT.pdf	No		Paper Only
Form	NIFA-08-10	Recommendation Form	VMLRP - NIFA-08-10 - Recommendation Form 09-14-10 DRAFT.pdf	No		Paper Only
Form	NIFA-09-10	Service Verification	VMLRP - NIFA-09-10 - Service Verification.pdf	No		Paper Only
Form	NIFA-0004	Loan Information	VMLRP_-_NIFA-04-10_-_Loan_Information_Form_09-11-10_DRAFT[1].pdf	Yes	No	Paper Only

Federal Enterprise Architecture Business Reference Module

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: 260

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,600	240	960	400
Annual IC Time Burden (Hours)	2,120	60	760	1,300
Annual IC Cost Burden (Dollars)	0	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.