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 4 PCL AOR revised	Form and Instruction	Modified	Available
Form 3 Non-PCL AOR revised	Form and Instruction	Modified	Available
Form 1 Deferment Form	Form and Instruction	Modified	Available
Form 1 AOR Guidance	Form and Instruction	Modified	Available
justification for non sub change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-03-24	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	PCL AOR revised
6331	Health Professions Student Loan and Nursing Student Loan Programs - Forms	Form and Instruction	Modified	Non-PCL AOR revised
6331	Health Professions Student Loan and Nursing Student Loan Programs - Forms	Form and Instruction	Modified	Deferment Form
6331	Health Professions Student Loan and Nursing Student Loan Programs - Forms	Form and Instruction	Modified	AOR Guidance

ICR Details

OMB Control No: 0915-0044	ICR Reference No: 201503-0915-001
Status: Historical Active	Previous ICR Reference No: 201411-0915-003
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Health Professions Student Loan and Nursing Student Loan Programs - 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: 04/01/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/25/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	01/31/2018	01/31/2018
Responses	5,684	0	5,684
Time Burden (Hours)	18,596	0	18,596
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, 1, 3, 4	AOR Guidance ,   Deferment Form ,   Non-PCL AOR revised ,   PCL AOR revised

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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	5,684	0	0	0	0
Annual Time Burden (Hours)	18,596	18,596	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: $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: 03/25/2015

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