Information Collection

Application for Contract of Federal Loan Insurance (HEAL Form 504)

IC 43609 under ICR 202106-1845-002 · OMB 1845-0128.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Application for Contract of Federal Loan Insurance (HEAL Form 504)	Form and Instruction
HEAL Form 504 Contract for Federal Loan Insurance HEAL Form 504.docx	Form and Instruction
HEAL Form 504 Contract for Federal Loan Insurance HEAL Form 504.docx	Form and Instruction
BLS_Tape_Specs.pdf BLS_Tape_Specs	IC Document
BLS_Tape_Specs.pdf BLS_Tape_Specs	IC Document
Loan_Pur_Consol_Tape_Specs.doc Loan_Pur_Consol_Tape_Specs	IC Document
Loan_Pur_Consol_Tape_Specs.doc Loan_Pur_Consol_Tape_Specs	IC Document

IC Title:

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	NA	HEAL Form 504 Contract for Federal Loan Insurance	HEAL Form 504.docx		No		Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Health Education Assistance Loan (HEAL) Program

FR Citation: 83 FR 157

Number of Respondents: 13

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	13	-46	59
Annual IC Time Burden (Hours)	2	-7	9
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
BLS_Tape_Specs	BLS_Tape_Specs.pdf	07/31/2012
Loan_Pur_Consol_Tape_Specs	Loan_Pur_Consol_Tape_Specs.doc	07/31/2012

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