Veterinary Medicine Loan Repayment Program (VMLRP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0524-New VMLRP Close-out Report Survey	Form	Unchanged	Available
Form 0524-New VMLRP Feedback Survey	Form	Unchanged	Available
Form 0524-New VMLRP Post Award Survey	Form	Unchanged	Available
Form 0524-New VMLRP Employer Survery	Form and Instruction	Unchanged	Available
Form NIFA -02-10 Personal Statement	Form	Modified	Available
Form NIFA -01-10 Applicant Information	Form	Modified	Available
Form NIFA -03-10 List of Recommenders	Form	Modified	Available
Form NIFA -04-10 Loan Information	Form	Modified	Available
Form NIFA -05-10 Contract	Form	Modified	Available
Form NIFA -06-10 Certification for Application	Form	Modified	Available
Form NIFA-07-10 Intent of Employment	Form	Modified	Available
Form NIFA -08-10 Recommendation Form	Form	Modified	Available
Form NIFA -09-10 Service Verification	Form	Modified	Available
Form NIFA 2009-0001 VMLRP Shortage Nomination Form	Form	Unchanged	Available
Change Request Memo.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2017-01-30	Repair queued
FY 2015 VMLRP Report_FINAL_2016-04-25.pptx	Supplementary Document	Uploaded 2016-09-01	Available
New VMLRP Guidance Document_.pdf	Supplementary Document	Uploaded 2016-06-28	Available
VMLRP Program Supporting Statement B 2016.docx	Supporting Statement B	Uploaded 2016-06-28	Available
VMLRP Program Supporting Statement.docx	Supporting Statement A	Uploaded 2016-09-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223387	Veterinary Medicine Loan Repayment Program Close-Out Reports	Form	Unchanged	VMLRP Close-out Report Survey
223385	Veterinary Medicine Loan Repayment Program Feedback Survey	Form	Unchanged	VMLRP Feedback Survey
223384	Veterinary Medicine Loan Repayment Post Award Survey	Form	Unchanged	VMLRP Post Award Survey
223383	Veterinary Medicine Loan Repayment Employer Survey	Form and Instruction	Unchanged	VMLRP Employer Survery
222271	Veterinary Medicine Loan Repayment Shortage Nomination Form Nonrespondents	Other-Place Holder	Unchanged
222231	Participant and Employer Feedback Surveys	Form	Modified	Personal Statement
222231	Participant and Employer Feedback Surveys	Form	Modified	Applicant Information
222231	Participant and Employer Feedback Surveys	Form	Modified	List of Recommenders
222231	Participant and Employer Feedback Surveys	Form	Modified	Loan Information
222231	Participant and Employer Feedback Surveys	Form	Modified	Contract
222231	Participant and Employer Feedback Surveys	Form	Modified	Certification for Application
222231	Participant and Employer Feedback Surveys	Form	Modified	Intent of Employment
222231	Participant and Employer Feedback Surveys	Form	Modified	Recommendation Form
222231	Participant and Employer Feedback Surveys	Form	Modified	Service Verification
222229	Participants and Employer Feedback Nonrespondents	Other-Non-Form Place holder	Unchanged
222227	Veterinary Medicine Loan Repayment Shortage Nomination Form	Form	Unchanged	VMLRP Shortage Nomination Form

ICR Details

OMB Control No: 0524-0050	ICR Reference No: 201701-0524-001
Status: Historical Active	Previous ICR Reference No: 201606-0524-002
Agency/Subagency: USDA/NIFA	Agency Tracking No:
Title: Veterinary Medicine Loan Repayment Program (VMLRP)
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: 02/03/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/30/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	09/30/2019	09/30/2019
Responses	42,250	0	42,250
Time Burden (Hours)	12,538	0	12,538
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection merges two previously approved information collections. OMB control number 0524-0046 and OMB control number 0524-0047, and adds new reporting and record keeping requirements, feedback, surveys and a post-contract survey. Upon approval of this collection 0524-0046 and 0524-0047 will be cancelled.

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Authorizing Statute(s): US Code: 7 USC 3151A Name of Law: National Agricultural Research Extension and Teaching Policy Act of 1997
  

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:
	80 FR 249	12/29/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 39888	06/20/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Participant and Employer Feedback Surveys	NIFA -02-10, NIFA -08-10, NIFA -06-10, NIFA-07-10, NIFA -05-10, NIFA -04-10, NIFA -03-10, NIFA -01-10, NIFA -09-10	Service Verification ,   Recommendation Form ,   Intent of Employment ,   Certification for Application ,   Contract ,   Loan Information ,   List of Recommenders ,   Applicant Information ,   Personal Statement
Participants and Employer Feedback Nonrespondents
Veterinary Medicine Loan Repayment Employer Survey	0524-New	VMLRP Employer Survery
Veterinary Medicine Loan Repayment Post Award Survey	0524-New	VMLRP Post Award Survey
Veterinary Medicine Loan Repayment Program Close-Out Reports	0524-New	VMLRP Close-out Report Survey
Veterinary Medicine Loan Repayment Program Feedback Survey	0524-New	VMLRP Feedback Survey
Veterinary Medicine Loan Repayment Shortage Nomination Form	NIFA 2009-0001	VMLRP Shortage Nomination Form
Veterinary Medicine Loan Repayment Shortage Nomination Form Nonrespondents

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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	42,250	42,250	0	0	0	0
Annual Time Burden (Hours)	12,538	12,538	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: This is a new submission merging two previously approved information collections (IC 0524-0046 and IC 0524-0047). As a result of merging the two collections and the additional information (Records and Reports, and Surveys) this resulted in a program change of 1,190 respondents, 41,280 responses, and 11,979 burden hours.

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Annual Cost to Federal Government: $154,514

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: 01/30/2017

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