Information Collection

HEAL form 508

IC 216521 under ICR 201505-1845-002 · OMB 1845-0128.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0128 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HEAL form 508	Form and Instruction
HEAL form 508 Draft HEAL form 508 60 day notice version 5 5 2015.docx	Form and Instruction

IC Title:

HEAL form 508

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	N/A	HEAL form 508	Draft HEAL form 508 60 day notice version 5 5 2015.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 83

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	88	88
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.