Information Collection

HEAL Lender's Application for Insurance Claim

IC 185895 under ICR 201108-0915-002 · OMB 0915-0036.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 HEAL Lender's Application for Insurance Claim	Form
LENDERS APPLICATION FOR INSURANCE FORM.docx	Instruction
2 Form 510 LENDER 510 FORM.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 60.40

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	2	Form 510	LENDER 510 FORM.docx		Yes	No	Fillable Fileable
Instruction			LENDERS APPLICATION FOR INSURANCE FORM.docx		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Health Educational Assistance Loan Program Loan Control Master File

FR Citation: 62 FR 5991

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: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	364	-61	425
Annual IC Time Burden (Hours)	182	-31	213
Annual IC Cost Burden (Dollars)	2,548	-502	3,050

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.