Health Professions Student Loan and Nursing Student Loan Programs - Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Health Professions Student Loan and Nursing Student Loan Programs - Forms	Form and Instruction	Modified	Available
Supporting Statement.docx	Supporting Statement A	Uploaded 2014-11-25	Available
0044_regs.doc	Supplementary Document	Uploaded 2009-03-12	Available
0044_law.doc	Supplementary Document	Uploaded 2009-03-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6331	Health Professions Student Loan and Nursing Student Loan Programs - Forms	Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0044	ICR Reference No: 201411-0915-003
Status: Historical Active	Previous ICR Reference No: 201204-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Health Professions Student Loan and Nursing Student Loan Programs - Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/16/2015
	Date Received in OIRA: 12/03/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	36 Months From Approved	07/31/2015
Responses	5,684	0	4,068
Time Burden (Hours)	18,596	0	11,733
Cost Burden (Dollars)	0	0	0

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Abstract: Under the HPSL Programs, the Department provides funds to schools for long-term, low interest loans to students attending schools of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, and pharmacy. Under the NSL Programs, the Department provides funds to schools of nursing for long-term, low interest loans to students in programs leading to a diploma in nursing, an associate degree, a baccalaureate degree, or a graduate degree in nursing.

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Authorizing Statute(s): US Code: 42 USC 292,297 Name of Law: Public Health Service Act, Sections 721-735
  

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:
	79 FR 58789	09/30/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 71439	12/02/2014
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 Professions Student Loan and Nursing Student Loan Programs - Forms	1, 4, 1, 3	AOR Guidance ,   Deferment Form ,   Non-PCL AOR ,   PCL AOR

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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	5,684	4,068	0	1,616	0	0
Annual Time Burden (Hours)	18,596	11,733	0	6,863	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: For the two forms (Deferment and AOR) in the OMB Inventory for 0915-0044, we are requesting 18,596 hours for an increase of approximately 6,863 burden hours. The current inventory for this is 11,733 hours. Specific form breakdown information follows. Deferment form (HRSA-519) We are requesting 2,132 total hours for the Deferment form (HRSA-519) which is an increase of 407 hours. Currently, there are 1,725 hours in the OMB Inventory for this form. The increase is due to: (1) The additional 1,666 forms being filled out (4,900 forms this time as opposed to 3,234 last time) and AOR (HRSA-501) We are requesting 16,464 hours total for the AOR (HRSA-501) which is an increase of 6,376 hours for the AOR. There are 10,088 hours currently in the OMB Inventory for this form. This change is due to the following: There were some new contacts established to provide estimates of reporting burden. Their estimates were different than the previous contacts.

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Annual Cost to Federal Government: $112,524

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: 12/03/2014

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