Information Collection

The NIH Extramural Loan Repayment Programs (LRP) Outcome Study

IC 221267 under ICR 201402-0925-002 · OMB 0925-0627.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0627 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 The NIH Extramural Loan Repayment Programs (LRP) Outcome Study	Form and Instruction
1 LRP Outcome Survey Screenshots Attach 3 - LRP Outcome Survey Screenshots 4-7-16.pdf	Form and Instruction
OMB Mini Supporting Statement - LRP Outcome Survey 4-7-16 (002).docx Mini SSA/B	IC Document
Attach 2 - LRP Outcome Survey IRB Approval 4-7-16.pdf IRB Approval	IC Document
Attach 3 - LRP Outcome Survey First Invitation Email 4-7-16.docx First Invitation	IC Document
Attach 4 - LRP Outcome Survey Second Invitation Email 4-7-16.docx Second Invitation	IC Document

IC Title:

The NIH Extramural Loan Repayment Programs (LRP) Outcome Study

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 Outcome Survey Screenshots	Attach 3 - LRP Outcome Survey Screenshots 4-7-16.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,440	1,440
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Mini SSA/B	OMB Mini Supporting Statement - LRP Outcome Survey 4-7-16 (002).docx	04/27/2016
IRB Approval	Attach 2 - LRP Outcome Survey IRB Approval 4-7-16.pdf	04/27/2016
First Invitation	Attach 3 - LRP Outcome Survey First Invitation Email 4-7-16.docx	04/27/2016
Second Invitation	Attach 4 - LRP Outcome Survey Second Invitation Email 4-7-16.docx	04/27/2016

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