Information Collection

Loan Repayment Program Survey: Renewal Application Process

IC 206192 under ICR 201112-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Loan Repayment Program Survey: Renewal Application Process	Form and Instruction
1 LRP Screenshots Attachement 3 - LRP Renewal Application Process Screenshots.pptx	Form and Instruction
Attachment 1 - First Invitation Email LRP Renewal Application Process Survey.docx Attachment 1 - First Invitation Email LRP Renewal Application Process Survey	IC Document
Attachment 2 - Second Invitation Email LRP Renewal Application Process Survey.docx Attachment 2 - Second Invitation Email LRP Renewal Application Process Survey	IC Document
Fasttrack Template LRP Renewal Application Process Survey.doc Fasttrack Template LRP Renewal Application Process Survey	IC Document

IC Title:

Loan Repayment Program Survey: Renewal Application Process

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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	1	LRP Screenshots	Attachement 3 - LRP Renewal Application Process Screenshots.pptx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

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 New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	60	0	0	0	0	0
Annual IC Time Burden (Hours)	5	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 1 - First Invitation Email LRP Renewal Application Process Survey	Attachment 1 - First Invitation Email LRP Renewal Application Process Survey.docx	03/13/2013
Attachment 2 - Second Invitation Email LRP Renewal Application Process Survey	Attachment 2 - Second Invitation Email LRP Renewal Application Process Survey.docx	03/13/2013
Fasttrack Template LRP Renewal Application Process Survey	Fasttrack Template LRP Renewal Application Process Survey.doc	03/13/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.