Information Collection

The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B

IC 224689 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B	Form and Instruction
LRP Applicant Survey Form B - Invitation Email.docx	Other-Email
1 LRP Survey for Applicants Form B- Screenshot LRP Survey for Applicants Form B - Screenshots.pdf	Form and Instruction
LRP Applicant Survey Form B - PCB Fasttrack Template.doc The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B	IC Document

IC Title:

The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants â Form B

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	LRP Survey for Applicants Form B- Screenshot	LRP Survey for Applicants Form B - Screenshots.pdf		Yes	Yes	Fillable Fileable
Other-Email			LRP Applicant Survey Form B - Invitation Email.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 594

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	594	594
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants â Form B	LRP Applicant Survey Form B - PCB Fasttrack Template.doc	12/02/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.