Financial Disclosure for Reasonable and Affordable Rehabilitation Payments Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0120 can be found here:

Documents and Forms

Document Name Document Type
Form 1845-0000 Financial Disclosure for Reasonable and Affordable Rehabilitation Payments Form Form and Instruction
1845-0000 Financial Disclosure for Reasonable and Affordable Rehab Financial Disclosure Form for Reasonable and Affordable Rehabilitation Payments 30 day comment period 05 01 13.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Financial Disclosure for Reasonable and Affordable Rehabilitation Payments Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 682.405 34 CFR 685.211

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1845-0000	Financial Disclosure for Reasonable and Affordable Rehabilitation Payments	Financial Disclosure Form for Reasonable and Affordable Rehabilitation Payments 30 day comment period 05 01 13.pdf		Yes	No	Printable Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 392,029	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	392,029	392,029
Annual IC Time Burden (Hours)	588,044	588,044
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.