Health Education Assistance Loan (HEAL) Program: Forms

Forms and Documents

Document	Type	Status	Availability
Health Education Assistance Loan (HEAL) Program: Forms	Form and Instruction	Modified	Available
Borrower Deferment Request (HEAL Form 508)	Form and Instruction	Modified	Available
30D 1845-0128 Supporting Statement 2018.docx	Supporting Statement A	Uploaded 2018-10-30	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
43609	Health Education Assistance Loan (HEAL) Program: Forms	Form and Instruction	Modified
216521	Borrower Deferment Request (HEAL Form 508)	Form and Instruction	Modified

ICR Details

OMB Control No: 1845-0128	ICR Reference No: 201808-1845-004
Status: Active	Previous ICR Reference No: 201505-1845-002
Agency/Subagency: ED/FSA	Agency Tracking No:
Title: Health Education Assistance Loan (HEAL) Program: Forms
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/20/2018
	Date Received in OIRA: 10/30/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2021	36 Months From Approved	12/31/2018
Responses	69	0	167
Time Burden (Hours)	11	0	24
Cost Burden (Dollars)	0	0	0

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Abstract: The HEAL forms are required for lenders to make application to the HEAL insurance program, to report accurately and timely on loan actions, including transfer of loans to a secondary agent, and to establish the repayment status of borrowers who qualify for deferment of payments using form 508. The reports assist in the diligent administration of the HEAL program, protecting the financial interest of the federal government.

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Authorizing Statute(s): US Code: 42 USC 292 Name of Law: Public Health Service Act
  

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:
	83 FR 43860	08/28/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 54578	10/30/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Borrower Deferment Request (HEAL Form 508)	N/A	HEAL form 508
Health Education Assistance Loan (HEAL) Program: Forms	N/A, N/A, N/A	HEAL form 504 ,   Borrower Loan Status Record ,   Loan Transfer Record Layout

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ICR Summary 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	69	167	0	0	-98	0
Annual Time Burden (Hours)	11	24	0	0	-13	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: The Department is requesting an extension of the currently approved information collection for HEAL forms 504 and 508 as well as the two data sets, Borrower Loan Status Updates and Loan Purchases and Consolidation. We are decreasing the total number of respondents to 21 from 96 (-75), responses to 69 from 167 (-98) and burden hours to 11 from 24 (-13). These changes are due to a decrease in HEAL servicer participation and the reduced number of borrowers who were in a deferred status at the end of FY17.

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Annual Cost to Federal Government: $3,120

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 10/30/2018

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