HEAL Lender's Application for Insurance Claim Form (Form 510)

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

OMB: 1845-0127

IC ID: 185895

Information Collection (IC) Details

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HEAL Lender's Application for Insurance Claim Form (Form 510)
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 60.40

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NA Form 510 HEAL form 510 Draft 2020.docx Yes No Fillable Printable
Instruction Instructions for HEAL form 510 Draft 2020.docx Yes No Printable Only

Education Higher Education

Health Education Assistance Loan  83 FR 40264

4 0
   
Private Sector Businesses or other for-profits
 
   92 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 75 0 0 -200 0 275
Annual IC Time Burden (Hours) 38 0 0 -100 0 138
Annual IC Cost Burden (Dollars) 375 0 0 -1,550 0 1,925

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