Heal 539

HEAL Program: Physician's Certification of Borrower's Total and Permanent Disability

Documents and Forms

Document Name Document Type
HEAL 539 Form and Instruction
HEAL Form 539.pdf Form and Instruction
HEAL Form 539.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	HEAL 539	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	N/A	HEAL Form 539.pdf		Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Health Education Assistance Loan (Altered)	FR Citation: 79 FR 36299

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	60	10	50
Annual IC Time Burden (Hours)	18	3	15
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.