NURSE Corps LRP Application

NURSE Corps Loan Repayment Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0140 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NURSE Corps LRP Application Form and Instruction
1 NC LRP - Application Form - Revised.docx NC LRP - Application Form - Revised.docx Form and Instruction
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf APPLICATION INSTRUCTIONS nelrp-online-application-user-guide IC Document

Information Collection (IC) Details

IC Title:	NURSE Corps LRP Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 1320.5(d)(2) 31 CFR 208, 210 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	NC LRP - Application Form - Revised.docx	NC LRP - Application Form - Revised.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Public Health Service and National Health Service Corps Scholarship/Loan Repayment Participants Records System	FR Citation: 58 FR 12968

Number of Respondents: 7,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	7,100	1,600	5,500
Annual IC Time Burden (Hours)	14,200	2,650	11,550
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
APPLICATION INSTRUCTIONS nelrp-online-application-user-guide	APPLICATION INSTRUCTIONS nelrp-online-application-user-guide.pdf	02/04/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.