HEAL Lender's Application for Insurance Claim - Form 510

Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form

OMB: 1845-0127

IC ID: 185895

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HEAL Lender's Application for Insurance Claim - Form 510
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 60.40

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NA Form 510 1845-0127 HEAL form 510 Draft 2017.docx Yes No Fillable Fileable
Instruction 1845-0127 Instructions for HEAL form 510 Draft 2017-Revised.docx Yes No Printable Only

Education Higher Education

Health Education Assistance Loan  79 FR 36299

13 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 275 0 0 -89 0 364
Annual IC Time Burden (Hours) 138 0 0 -44 0 182
Annual IC Cost Burden (Dollars) 1,925 0 0 -623 0 2,548

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