Information Collection

Veterinary Medicine Loan Repayment Program Application

IC 191731 under ICR 201406-0524-001 · OMB 0524-0047.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NIFA -01-10 Veterinary Medicine Loan Repayment Program Application	Form
NIFA -01-10 Loan Application Information VMLRP - NIFA-01-10 - Applicant Information.doc	Form
NIFA-02-10 Personal Statement VMLRP - NIFA-02-10 - Personal Statement.doc	Form
NIFA-06-10 Certifications for Application VMLRP - NIFA-06-10 - Certifications for Application.doc	Form
NIFA-07-10 Intent of Employment VMLRP - NIFA-07-10 - Intent of Employment.doc	Form
NIFA-08-10 Recommendation Form VMLRP - NIFA-08-10 - Recommendation Form.doc	Form
Form-03-10 List of Recommendaters VMLRP - NIFA-03-10 - List of Recommenders.doc	Form
NIFA-05-10 Contract VMLRP - NIFA-05-10 - Contract SAMPLE.doc	Form
NIFA-09-10 Service Verification VMLRP - NIFA-09-10 - Service Verification.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 3431

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	NIFA -01-10	Loan Application Information	VMLRP - NIFA-01-10 - Applicant Information.doc	No	Paper Only
Form	NIFA-02-10	Personal Statement	VMLRP - NIFA-02-10 - Personal Statement.doc	No	Paper Only
Form	NIFA-06-10	Certifications for Application	VMLRP - NIFA-06-10 - Certifications for Application.doc	No	Paper Only
Form	NIFA-07-10	Intent of Employment	VMLRP - NIFA-07-10 - Intent of Employment.doc	No	Paper Only
Form	NIFA-08-10	Recommendation Form	VMLRP - NIFA-08-10 - Recommendation Form.doc	No	Paper Only
Form	Form-03-10	List of Recommendaters	VMLRP - NIFA-03-10 - List of Recommenders.doc	No	Paper Only
Form	NIFA-05-10	Contract	VMLRP - NIFA-05-10 - Contract SAMPLE.doc	No	Paper Only
Form	NIFA-09-10	Service Verification	VMLRP - NIFA-09-10 - Service Verification.doc	No	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	102	-1,498	1,600
Annual IC Time Burden (Hours)	1,000	-1,120	2,120
Annual IC Cost Burden (Dollars)	0	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.