Holder's Report on Health Education Assistance Loans HEAL Form 512

Health Education Assistance Loan (HEAL)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0126 can be found here:

Documents and Forms

Document Name Document Type
Holder's Report on Health Education Assistance Loans HEAL Form 512 Form and Instruction
512 HEAL form 512 60 day comment.docm Form and Instruction

Information Collection (IC) Details

IC Title:	Holder's Report on Health Education Assistance Loans HEAL Form 512	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	512	HEAL form 512 60 day comment.docm		Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Health Education Program	FR Citation: 79 FR 123

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40	-20	60
Annual IC Time Burden (Hours)	30	-15	45
Annual IC Cost Burden (Dollars)	0	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.