National Institutes of Health Loan Repayment Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Applicant Information	Form and Instruction	Modified	Repair queued
Form 3 Recommender and Institution Contacts	Form and Instruction	Modified	Repair queued
Form 2 Advisors and Supervisors	Form and Instruction	Modified	Repair queued
Form 1 Applicant Information	Form and Instruction	Modified	Available
Form 2 Advisors and Supervisors	Form and Instruction	Modified	Available
Form 1 Applicant Information	Form and Instruction	Modified	Repair queued
Form 1 Application	Form	Removed	Repair queued
Form 3 Recommender and Institution Contacts	Form and Instruction	Modified	Repair queued
Form 2 Advisors and Supervisors	Form and Instruction	Modified	Available
Form 1 Applicant Information	Form and Instruction	Modified	Repair queued
Form 1 Application	Form	Removed	Repair queued
Form 3 Recommender and Institution Contacts	Form and Instruction	Modified	Repair queued
Form 2 Advisors and Supervisors	Form and Instruction	Modified	Repair queued
LRP Public Comment.docx	Supplementary Document	Uploaded 2014-04-24	Available
0925-0361 Loan Repayment Supporting_Statement A REVISED.docx	Supporting Statement A	Uploaded 2014-06-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7282	Intramural/InitialApplications	Form and Instruction	Modified	Applicant Information
7282	Intramural/InitialApplications	Instruction	Modified
184374	Extramural/ Recommenders and Institution Contacts	Form and Instruction	Modified	Recommender and Institution Contacts
184374	Extramural/ Recommenders and Institution Contacts	Instruction	Modified
184373	Extramural/ Advisors and Supervisors	Form and Instruction	Modified	Advisors and Supervisors
184373	Extramural/ Advisors and Supervisors	Instruction	Modified
184372	Extramural/ Renewal Applicants	Form and Instruction	Modified	Applicant Information
184372	Extramural/ Renewal Applicants	Instruction	Modified
184371	Intramural/ Advisors and Supervisors	Form and Instruction	Modified	Advisors and Supervisors
184371	Intramural/ Advisors and Supervisors	Instruction	Modified
184370	Intramural/ Renewal Applications	Form and Instruction	Modified	Applicant Information
184370	Intramural/ Renewal Applications	Instruction	Modified
184369	Extramural/ Financial Institutions	Form	Removed	Application
184369	Extramural/ Financial Institutions	Instruction	Removed
184368	Extramural/ Recommenders and Institution Contacts	Form and Instruction	Modified	Recommender and Institution Contacts
184368	Extramural/ Recommenders and Institution Contacts	Instruction	Modified
184367	Extramural/ Advisors and Supervisors	Form and Instruction	Modified	Advisors and Supervisors
184367	Extramural/ Advisors and Supervisors	Instruction	Modified
184366	Extramural/ Initial Applicants	Form and Instruction	Modified	Applicant Information
184366	Extramural/ Initial Applicants	Instruction	Modified
184365	Intramural/ Financial Institutions	Form	Removed	Application
184365	Intramural/ Financial Institutions	Instruction	Removed
184364	Intramural/Recommenders and Institution Contacts	Form and Instruction	Modified	Recommender and Institution Contacts
184364	Intramural/Recommenders and Institution Contacts	Instruction	Modified
184363	Intramural/Advisors and Supervisors	Form and Instruction	Modified	Advisors and Supervisors
184363	Intramural/Advisors and Supervisors	Instruction	Modified

ICR Details

OMB Control No: 0925-0361	ICR Reference No: 201404-0925-001
Status: Historical Active	Previous ICR Reference No: 201211-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: National Institutes of Health Loan Repayment Programs
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/09/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/28/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	13,390	0	16,090
Time Burden (Hours)	34,925	0	41,664
Cost Burden (Dollars)	0	0	0

---

Abstract: The NIH Loan Repayment Programs are designed to attract highly qualified physicians and other scientific or medical personnel to research opportunities at the National Institutes of Health (NIH, Intramural) and Non-NIH sites (Extramural). There are a total of 3 Intramural and 5 Extramural programs. Intramural includes AIDS Research Loan Repayment Program (AIDS-LRP), the General Research LRP (GR-LRP), which includes a program for the Accreditation Council for Graduate Medical Education (ACGME) Fellows, and the Clinical Research LRP for Individuals from Disadvantaged Backgrounds (CR-LRP). The Extramural programs include Clinical Research LRP for Individuals from Disadvantaged Backgrounds (ECR-LRP), the Pediatric Research LRP (PR-LRP), the Contraception and Infertility Research LRP (CIR-LRP), the Health Disparities Research LRP (HD-LRP), and the Clinical Research LRP (LRP-CR). Data collected through application forms is necessary to determine an applicant's eligibility for the program, including his or her research plans and career interests. The forms presented to the applicant vary based on the application type, Initial/New or Renewal. Each initial applicant is expected to spend approximately 11 hours completing and assembling the application package, and each renewal applicant approximately 7 hours. Both applications require supporting online forms to be completed by their colleagues.

---

Authorizing Statute(s): US Code: 42 USC 288-1 Name of Law: AIDS Research loan Repayment Program
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 5440	01/31/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 20893	04/14/2014
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 11

table that charts list of burden

IC Title	Form No.	Form Name
Extramural/ Advisors and Supervisors	2	Advisors and Supervisors
Extramural/ Advisors and Supervisors	2	Advisors and Supervisors
Extramural/ Financial Institutions	1	Application
Extramural/ Initial Applicants	1	Applicant Information
Extramural/ Recommenders and Institution Contacts	3	Recommender and Institution Contacts
Extramural/ Recommenders and Institution Contacts	3	Recommender and Institution Contacts
Extramural/ Renewal Applicants	1	Applicant Information
Intramural/ Advisors and Supervisors	2	Advisors and Supervisors
Intramural/ Financial Institutions	1	Application
Intramural/ Renewal Applications	1	Applicant Information
Intramural/Advisors and Supervisors	2	Advisors and Supervisors
Intramural/InitialApplications	1	Applicant Information
Intramural/Recommenders and Institution Contacts	3	Recommender and Institution Contacts

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	13,390	16,090	0	-2,700	0	0
Annual Time Burden (Hours)	34,925	41,664	0	-6,739	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden hours for the eight programs have decreased by 6737 hours and one half-hour. This number reflects adjustments for the fewer number of initial applicants for the intramural (from 50 applicants to 20 applicants) and extramural programs (from 2,050 applicants to 1,800 applicants). These changes will bring the total burden hours for the eight programs to 34,925 hours.

---

Annual Cost to Federal Government: $901,660

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/28/2014

---