Health Education Assistance Loan (HEAL) Program: Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Health Education Assistance Loan (HEAL) Program: Forms	Form and Instruction	Modified	Available
83C for 1845-0128 HEAL form 504 and 508.pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2014-06-24	Available
Loan_Pur_Consol_Tape_Specs.doc	Supplementary Document	Uploaded 2012-07-31	Available
BLS_Tape_Specs.pdf	Supplementary Document	Uploaded 2012-07-31	Repair queued
Supporting Statement.doc	Supporting Statement A	Uploaded 2012-07-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43609	Health Education Assistance Loan (HEAL) Program: Forms	Form and Instruction	Modified

ICR Details

OMB Control No: 1845-0128	ICR Reference No: 201406-1845-019
Status: Historical Active	Previous ICR Reference No: 201406-1845-005
Agency/Subagency: ED/FSA	Agency Tracking No: 2041
Title: Health Education Assistance Loan (HEAL) Program: Forms
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/25/2014
	Date Received in OIRA: 06/24/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2015	09/30/2015	09/30/2015
Responses	151	0	151
Time Burden (Hours)	23	0	23
Cost Burden (Dollars)	0	0	0

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Abstract: The HEAL forms are required for lenders to make application to the HEAL insurance program, to report accurately and timely on loan actions, including transfer of loans to a secondary agent, and to establish the repayment status of borrowers. These reports assist DHHS in diligent administration of the HEAL program which protects the Government's financial interest. Section 525 of the Consolidated Appropriations Act, 2014 transferred the collection of the Health Education Assistance Loan (HEAL) program loans from the US Department of Health and Human Services (HHS) to the US Department of Education (ED). To fulfill this mandate, ED requested and received the transfer of the currently approved forms to a new collection under Federal Student Aid OMB Control Number prefix 1845. The changes to the approved forms will be to identify ED as the agency owner of the HEAL loans, identify new contact information, and minor spelling corrections.

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Authorizing Statute(s): US Code: 42 USC 292 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 28605	05/15/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 42749	07/20/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Health Education Assistance Loan (HEAL) Program: Forms	1, 2	HRSA 504 ,   HRSA 508

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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	151	151	0	0	0	0
Annual Time Burden (Hours)	23	23	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2,480

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

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Common Form ICR:  No

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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: 06/24/2014

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