Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP)

ICR 202305-0906-003

OMB: 0906-0058

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0906-0058 can be found here:

2023-07-20 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
Form 8 PS LRP Employment Verification Form Form and Instruction	New
Form 7 PS LRP Privacy Act Release Authorization Form Form and Instruction	New
Form 6 Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form Form and Instruction	New
Form 5 Pediatric Specialty LRP Application Form and Instruction	New
Form 5 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application Form and Instruction	Removed
Form 4 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form Form and Instruction	Modified
Form 3 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form Form and Instruction	Modified
Form 2 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information Form and Instruction	Modified
Form 1 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application Form and Instruction	Modified
STAR LRP + Ped Spec LRP Supporting Statement -.docx Supporting Statement A	2023-05-23

IC Document Collections

IC ID	Document Title	Status
260337	PS LRP Employment Verification Form Form and Instruction	New
260336	PS LRP Privacy Act Release Authorization Form Form and Instruction	New
260334	Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form Form and Instruction	New
260333	Pediatric Specialty LRP Application Form and Instruction	New
243488	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application Form and Instruction	Removed
243487	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form Form and Instruction	Modified
243486	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form Form and Instruction	Modified
243485	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information Form and Instruction	Modified
243484	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application Form and Instruction	Modified

ICR Details

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