Information Collection

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

IC 185895 under ICR 202303-1845-005 · OMB 1845-0127.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HEAL Lender's Application for Insurance Claim Form (Form 510)	Form
Instructions for HEAL form 510 Draft 2023.docx	Instruction
Instructions for HEAL form 510 Draft 2023.docx	Instruction
Form 510 HEAL form 510 Draft 2023.docx	Form
Form 510 HEAL form 510 Draft 2023.docx	Form

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: 45 CFR 60.40

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	NA	Form 510	HEAL form 510 Draft 2023.docx		Yes	No	Fillable Printable
Instruction			Instructions for HEAL form 510 Draft 2023.docx		Yes	No	Printable Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Health Education Assistance Loan

FR Citation: 83 FR 40264

Number of Respondents: 4

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 92 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	375	375

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.