Information Collection

LLoan Discharge Application: False Certification Disqualifying Status

IC 212117 under ICR 201704-1845-005 · OMB 1845-0058.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0058 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
LLoan Discharge Application: False Certification Disqualifying Status	Form and Instruction
False Certification Disqualifying Status 1845-0058 FC-DS_20170720.pdf	Form and Instruction

IC Title:

LLoan Discharge Application: False Certification Disqualifying Status

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 682 34 CFR 685

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	False Certification Disqualifying Status	1845-0058 FC-DS_20170720.pdf		Yes	Yes	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Common Services for Borrower (CSB) System

FR Citation: 79 FR 117

Number of Respondents: 1,290

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	Previously Approved
Annual Number of Responses for this IC	1,290	1,290
Annual IC Time Burden (Hours)	645	645
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.