Veterinary Medicine Loan Repayment Program (VMLRP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0524-New VMLRP Close-out Report Survey	Form	Removed	Available
Form VMLRP NIFA VMLRP Post Award Survey	Form and Instruction	Modified	Available
Form VMLRP NIFA VNLRP Employer Survey	Form and Instruction	Modified	Available
Form VMLRP NIFA-09-10 Service Verification Form	Form and Instruction	Modified	Available
Form VMLRP NIFA Close-out Report	Form and Instruction	Modified	Available
Form VMLRP NIFA-00-10 Feedback Survey Form VV	Form and Instruction	Modified	Available
Form VMLRP NIFA-09-10 Service Verification Form	Form and Instruction	Modified	Available
Form VMLRP - NIFA-04-10 Loan Information Form	Form and Instruction	Modified	Repair queued
Form NIFA-03-10 List of Recommenders	Form and Instruction	Modified	Available
Form VMLRP -NIFA-07-10 Intent of Employee Form	Form and Instruction	Modified	Available
Form VMLRP - NIFA-06-10 Certifications for Application Form	Form and Instruction	Modified	Available
Form VMLRP NIFA-05-10 Contract Form	Form and Instruction	Modified	Available
Form VMLRP -NIFA-04-10 Loan Information Form	Form and Instruction	Modified	Available
Form VMLRP - NIFA-03-10 List of Recommenders	Form and Instruction	Modified	Available
Form VMLRP -NIFA-02-10 Personal Statement	Form and Instruction	Modified	Available
Form VMLRP - NIFA-01-10 Applicant Information	Form and Instruction	Modified	Available
Form NIFA Form 2009-000 VMLRP Shortage Nomination Form	Form and Instruction	Modified	Available
VMLRP Program Supporting Statement.docx	Supporting Statement A	Uploaded 2019-10-21	Available
New VMLRP Guidance Document_.pdf	Supplementary Document	Uploaded 2019-10-18	Available
VMLRP Program Supporting Statement B 2019.docx	Supporting Statement B	Uploaded 2019-10-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223387	Veterinary Medicine Loan Repayment Program Close-Out Reports	Form	Removed	VMLRP Close-out Report Survey
223385	Past Participants	Form and Instruction	Modified	VMLRP Post Award Survey
223384	Employers	Form and Instruction	Modified	VNLRP Employer Survey
223384	Employers	Form and Instruction	Modified	Service Verification Form
223383	Current Participants	Form and Instruction	Modified	Close-out Report
223383	Current Participants	Form and Instruction	Modified	Feedback Survey Form VV
223383	Current Participants	Form and Instruction	Modified	Service Verification Form
222271	Finanicial Institutions	Form and Instruction	Modified	Loan Information Form
222231	Recommenders	Form and Instruction	Modified	List of Recommenders
222229	Applicants	Form and Instruction	Modified	Intent of Employee Form
222229	Applicants	Form and Instruction	Modified	Certifications for Application Form
222229	Applicants	Form and Instruction	Modified	Contract Form
222229	Applicants	Form and Instruction	Modified	Loan Information Form
222229	Applicants	Form and Instruction	Modified	List of Recommenders
222229	Applicants	Form and Instruction	Modified	Personal Statement
222229	Applicants	Form and Instruction	Modified	Applicant Information
222227	State Animal Health Officials	Form and Instruction	Modified	VMLRP Shortage Nomination Form

ICR Details

OMB Control No: 0524-0050	ICR Reference No: 201910-0524-001
Status: Historical Active	Previous ICR Reference No: 201701-0524-001
Agency/Subagency: USDA/NIFA	Agency Tracking No:
Title: Veterinary Medicine Loan Repayment Program (VMLRP)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/19/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/12/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2022	36 Months From Approved
Responses	41,520	0	0
Time Burden (Hours)	12,458	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection adds new reporting and record keeping requirements, feedback, surveys and a post-contract survey.

---

Authorizing Statute(s): US Code: 7 USC 3151A Name of Law: National Agricultural Research Extension and Teaching Policy Act of 1997
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 169	08/30/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 169	09/20/2019
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Applicants	VMLRP - NIFA-06-10, VMLRP - NIFA-01-10, VMLRP -NIFA-07-10, VMLRP -NIFA-02-10, VMLRP -NIFA-04-10, VMLRP - NIFA-03-10, VMLRP NIFA-05-10	Applicant Information ,   Personal Statement ,   List of Recommenders ,   Loan Information Form ,   Contract Form ,   Certifications for Application Form ,   Intent of Employee Form
Current Participants	VMLRP NIFA, VMLRP NIFA-00-10, VMLRP NIFA-09-10	Service Verification Form ,   Feedback Survey Form VV ,   Close-out Report
Employers	VMLRP NIFA, VMLRP NIFA-09-10	Service Verification Form ,   VNLRP Employer Survey
Finanicial Institutions	VMLRP - NIFA-04-10	Loan Information Form
Past Participants	VMLRP NIFA	VMLRP Post Award Survey
Recommenders	NIFA-03-10	List of Recommenders
State Animal Health Officials	NIFA Form 2009-0001	VMLRP Shortage Nomination Form
Veterinary Medicine Loan Repayment Program Close-Out Reports	0524-New	VMLRP Close-out Report Survey

---

ICR Summary of Burden

table that charts list 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	41,520	0	0	-50	-680	42,250
Annual Time Burden (Hours)	12,458	0	0	-17	-63	12,538
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The change in burden has increased because this is a reinstatement of a previously approved collection which resulted in a program change of 12, 458 burden hours.

---

Annual Cost to Federal Government: $154,514

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

---

Common Form ICR:  No

---

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: 11/12/2019

---