Information Collection

Employment Certification for Public Service Loan Forgiveness

IC 198201 under ICR 201203-1845-001 · OMB 1845-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Employment Certification for Public Service Loan Forgiveness	Form
Instructions_83C_12052011.docx	Instruction
1845-0110 PSLF ECF Instructions_Final_Blackline_20120307.docx	Instruction
Employment Certification for Public Service Loan Forgive ECF_83C_12052011.docx	Form
Public Service Loan Forgiveness Employment Certification 1845-0110 PSLF ECF_Final_Blackline_20120306.docx	Form

IC Title:

Employment Certification for Public Service Loan Forgiveness

Agency IC Tracking Number:

4822

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 685.219

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	N/A	Employment Certification for Public Service Loan Forgiveness	ECF_83C_12052011.docx	Yes	No	Paper Only
Instruction			Instructions_83C_12052011.docx	Yes	No	Paper Only
Instruction			1845-0110 PSLF ECF Instructions_Final_Blackline_20120307.docx	Yes	Yes	Fillable Fileable
Form	N/A	Public Service Loan Forgiveness Employment Certification Form	1845-0110 PSLF ECF_Final_Blackline_20120306.docx	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Common Services for Borrowers

FR Citation: 75 FR 59242

Number of Respondents: 2,073,643

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	Previously Approved
Annual Number of Responses for this IC	2,073,643	2,073,643
Annual IC Time Burden (Hours)	1,036,822	1,036,822
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.