Employment Certification for Public Service Loan Forgiveness

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0110 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Employment Certification for Public Service Loan Forgiveness Form and Instruction
1 Employment Certification for Public Service Loan Forgive 1845-0110_PSLF ECF_20141124_Clean.docx studentaid.gov/publicservice Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employment Certification for Public Service Loan Forgiveness	Agency IC Tracking Number:	1474.07

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 685.219

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Employment Certification for Public Service Loan Forgiveness	1845-0110_PSLF ECF_20141124_Clean.docx	https://studentaid.gov/publicservice	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Common Services for Borrowers	FR Citation: 75 FR 59242

Number of Respondents: 122,896	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	122,896	-1,950,747	2,073,643
Annual IC Time Burden (Hours)	61,448	-975,374	1,036,822
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.