Information Collection

Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form - Form 513

IC 6323 under ICR 201705-1845-002 · OMB 1845-0127.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0127 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form - Form 513	Form
513 Form 1845-0127 HEAL form 513 Draft 2017-Revised.doc	Form

IC Title:

Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form - Form 513

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 60.35

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	NA	513 Form	1845-0127 HEAL form 513 Draft 2017-Revised.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Health Education Assistance Loan

FR Citation: 79 FR 36299

Number of Respondents: 13

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 92 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,338	0	-1,447	5,785
Annual IC Time Burden (Hours)	737	0	-246	983
Annual IC Cost Burden (Dollars)	35	-11	0	46

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.