Information Collection

Nurse Faculty Loan Program (NFLP) Program Specific Data Form

IC 210369 under ICR 201402-0915-004 · OMB 0915-0378.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0378 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Nurse Faculty Loan Program (NFLP) Program Specific Data Form	Form and Instruction
1 Nurse Faculty Loan Program (NFLP) Program Specific Data 2014 Blank Formatted NFLP Application Data Form.docx	Form and Instruction

IC Title:

Nurse Faculty Loan Program (NFLP) Program Specific Data 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:

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	Nurse Faculty Loan Program (NFLP) Program Specific Data Form	2014 Blank Formatted NFLP Application Data Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	1,200	1,200
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.