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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
513 Form	Form	Modified	Available
HEAL Request for Collection Assistance Form (Form 513)	Form	Modified	Repair queued
Form 510	Form	Modified	Available
HEAL Lender's Application for Insurance Claim Form (Form 510)	Form	Modified	Repair queued
1845-0127 Supporting Statement 30D 2023 rev.docx	Supporting Statement A	Uploaded 2023-05-31	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6323	HEAL Request for Collection Assistance Form (Form 513)	Form	Modified	513 Form
6323	HEAL Request for Collection Assistance Form (Form 513)	Form	Modified
185895	HEAL Lender's Application for Insurance Claim Form (Form 510)	Form	Modified	Form 510
185895	HEAL Lender's Application for Insurance Claim Form (Form 510)	Form	Modified
185895	HEAL Lender's Application for Insurance Claim Form (Form 510)	Instruction	Modified

ICR Details

OMB Control No: 1845-0127	ICR Reference No: 202303-1845-005
Status: Active	Previous ICR Reference No: 202003-1845-001
Agency/Subagency: ED/FSA	Agency Tracking No: ED-2023-SCC-0051
Title: Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/04/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/05/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	36 Months From Approved	08/31/2023
Responses	296	0	296
Time Burden (Hours)	76	0	76
Cost Burden (Dollars)	928	0	928

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Abstract: This is a request for an extension of Office of Management and Budget (OMB) approval of the Lender’s Application for Insurance Claim Form (HEAL 510) and Request for Collection Assistance Form (HEAL 513). Section 525 of the Consolidated Appropriations Act of 2014 transferred the collection of the HEAL Program loans from the U.S. Department of Health and Human Services (HHS) to the U.S. Department of Education (the Department). The information collected on both forms is necessary to protect the financial interests of the Federal Government and to assure proper program administration by the current lenders/holders.

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Authorizing Statute(s): PL: Pub.L. 102 - 408 101 Name of Law: Health Professions Education Amendments of 1992
   PL: Pub.L. 105 - 392 101 Name of Law: Health Professions Education and Financial Assistance Programs
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 16962	03/21/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 36558	06/05/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
HEAL Lender's Application for Insurance Claim Form (Form 510)	NA	Form 510
HEAL Request for Collection Assistance Form (Form 513)	NA	513 Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	296	296	0	0	0	0
Annual Time Burden (Hours)	76	76	0	0	0	0
Annual Cost Burden (Dollars)	928	928	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/05/2023

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