Information Collection

Nurse Faculty Loan Program (NFLP) Program Specific Data Form

IC 210369 under ICR 201704-0915-003 · OMB 0915-0378.

Documents and Forms

Document Name Document Type
Form 1 Nurse Faculty Loan Program (NFLP) Program Specific Data Form Form and Instruction
1 Blank NFLP Application Data Form 0378.docx Blank NFLP Application Data Form 0378.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Nurse Faculty Loan Program (NFLP) Program Specific Data Form	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	1	Blank NFLP Application Data Form 0378.docx	Blank NFLP Application Data Form 0378.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	90	-60	150
Annual IC Time Burden (Hours)	720	-480	1,200
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.