Third Party Servicer Data Form

Third Party Servicer Data Collection

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0130 can be found here:

Documents and Forms

Document Name Document Type
Third Party Servicer Data Form Form and Instruction
Third Party Servicer Data Form Third Party Servicer Data Form 01 09 15.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Third Party Servicer Data Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 668.25

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Third Party Servicer Data Form	Third Party Servicer Data Form 01 09 15.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	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.