Extramural/ Recommenders

National Institutes of Health Loan Repayment Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0361 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Extramural/ Recommenders Form
LRP Instructions for Data Collection Instruments.doc Instruction
1 Application LRP Data Collection Instruments.pdf Form

Information Collection (IC) Details

IC Title:	Extramural/ Recommenders	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Application	LRP Data Collection Instruments.pdf		Yes	Yes	Fillable Fileable
Instruction			LRP Instructions for Data Collection Instruments.doc		Yes	Yes	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,500	3,500
Annual IC Time Burden (Hours)	1,750	1,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.