Information Collection

Service Payback Agreement

IC 234892 under ICR 202205-1810-002 · OMB 1810-0698.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0698 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Service Payback Agreement	Form
Service Payback Agreement 1810-0698 PD_payback_agreement 04182019.docx	Form
Service Payback Agreement 1810-0698 PD_payback_agreement 04182019.docx	Form

IC Title:

Service Payback Agreement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	N/A	Service Payback Agreement	1810-0698 PD_payback_agreement 04182019.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-440	440
Annual IC Time Burden (Hours)	-400	400
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.