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Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP)
OMB: 0906-0058
IC ID: 243487
OMB.report
HHS/HRSA
OMB 0906-0058
ICR 202305-0906-003
IC 243487
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0058 can be found here:
2023-07-20 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 4
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form
Form and Instruction
4 STAR LRP Employment Verification Form
STAR LRP EVF.docx
Form and Instruction
Information Collection (IC) Details
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