Application and Employment Certification for Public Service Loan Forgiveness

Forms and Documents

Document Name	Status
Application and Employment Certification for Public Service Loan Forgiveness Forms Form and Instruction	Modified
PSLF Form Comments.docx Supplementary Document	2017-04-12
PSLF Anonymous Comments and FSA Replies 3 2017.docx Supplementary Document	2017-03-02
Final combined ICR comment responses 3 2 2017.docx Supplementary Document	2017-03-02
suppstatptA_20170228.docx Supporting Statement A	2017-03-02

IC Document Collections

IC ID	Document Title	Status
198201	Application and Employment Certification for Public Service Loan Forgiveness Forms Form and Instruction	Modified

ICR Details

OMB Control No: 1845-0110	ICR Reference No: 201612-1845-006
Status: Historical Active	Previous ICR Reference No: 201407-1845-002
Agency/Subagency: ED/FSA	Agency Tracking No:
Title: Application and Employment Certification for Public Service Loan Forgiveness
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: 05/24/2017
	Date Received in OIRA: 03/09/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	12/31/2017
Responses	728,419	0	122,896
Time Burden (Hours)	364,210	0	61,448
Cost Burden (Dollars)	0	0	0

---

Abstract: Final regulations for the Public Service Loan Forgiveness (PSLF) Program were published in the Federal Register on October 23, 2008 (73 FR 63256) and were codified in 34 CFR 685.219. These regulations require a borrower to submit an application for loan forgiveness to the U.S. Department of Education (the Department). To determine whether a borrower is eligible for loan forgiveness, the Department must confirm that the borrower was employed full-time by a qualifying public service organization at the time each of the required 120 payments was made. Because borrowers must make 120 payments on or after October 1, 2007 before becoming eligible for forgiveness, the earliest that any borrower could apply for forgiveness under PSLF would be October 1, 2017. The Department is creating an application for forgiveness and revising the Employment Certification Form which is already part of this collection. Pages 2 through 6 of the current Employment Certification Form will also be embedded in the application. Slight changes have been made to the language on the Employment Certification Form to increase consistency and understanding.

---

Authorizing Statute(s): US Code: 20 USC 1087(e)(m) Name of Law: Higher Education Act of 1965, as amended
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 90820	12/15/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 13102	03/09/2017
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application and Employment Certification for Public Service Loan Forgiveness Forms	N/A, N/A, N/A	1845-0110 PSLF APP ,   1845-0110 PSLF ECF ,   1845-0110 PSLF Core

---

ICR Summary 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	728,419	122,896	0	605,523	0	0
Annual Time Burden (Hours)	364,210	61,448	0	302,762	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: This revision represents an increase of 302,762 burden hours. The burden increase is the result of two factors. First, there is a new form—the Application form—for borrowers to submit as part of this collection. Second, more and more borrowers have been submitting the Employment Certification Form than when the collection was previously approved.

---

Annual Cost to Federal Government: $0

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

---

Common Form ICR:  No

---

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: 03/09/2017

---