Information Collection

Heal 539

IC 6427 under ICR 201907-1845-004 · OMB 1845-0124.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0124 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
N/A HEAL 539	Form and Instruction
HEAL Form 539 updated draft for 60 day clearance review 2019.doc	Form and Instruction

IC Title:

HEAL 539

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:

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				Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Health Education Assistance Loan (Altered)

FR Citation: 79 FR 36299

Number of Respondents: 50

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	50	50
Annual IC Time Burden (Hours)	15	15
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.

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