OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202305-0906-003 · OMB 0906-0058 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 8 PS LRP Employment Verification Form Form and Instruction New Repair queued
Form 7 PS LRP Privacy Act Release Authorization Form Form and Instruction New Repair queued
Form 6 Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form Form and Instruction New Repair queued
Form 5 Pediatric Specialty LRP Application Form and Instruction New Repair queued
Form 5 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application Form and Instruction Removed Repair queued
Form 4 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form Form and Instruction Modified Repair queued
Form 3 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form Form and Instruction Modified Repair queued
Form 2 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information Form and Instruction Modified Repair queued
Form 1 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application Form and Instruction Modified Missing upstream
STAR LRP + Ped Spec LRP Supporting Statement -.docx Supporting Statement A Uploaded 2023-05-23 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
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
StatusReceived in OIRA
Agency/SubagencyHHS/HRSA
OMB Control No0906-0058
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202009-0906-001
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31