HEAL Request for Collection Assistance Form (Form 513)

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

Documents and Forms

Document Name Document Type
HEAL Request for Collection Assistance Form (Form 513) Form
513 Form HEAL form 513 Draft 2023.docx Form
513 Form HEAL form 513 Draft 2023.docx Form

Information Collection (IC) Details

IC Title:	HEAL Request for Collection Assistance Form (Form 513)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 60.35

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA	513 Form	HEAL form 513 Draft 2023.docx		Yes	Yes	Fillable Fileable

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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	221	221
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	553	553

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.