Application and Employment Certification for Public Service Loan Forgiveness

ICR 202305-1845-004

OMB: 1845-0110

Federal Form Document

Forms and Documents
Form and Instruction
Supplementary Document
Supplementary Document
Supplementary Document
Supporting Statement A
IC Document Collections
ICR Details
1845-0110 202305-1845-004
Received in OIRA 202305-1845-001
ED/FSA ED-2023-SCC-0079
Application and Employment Certification for Public Service Loan Forgiveness
Extension without change of a currently approved collection   No
Regular 09/07/2023
  Requested Previously Approved
36 Months From Approved 11/30/2023
913,713 913,713
456,857 456,857
0 0

The Department of Education (Department) is requesting an emergency clearance for this renewal of the revision of the information collection, 1845-0110. Additionally, we are requesting that the full clearance package be filed at the same time and that the Department will initiate the 60-day public comment period upon notification of emergency approval. The PSLF program was revised during the Negotiated Rulemaking process in 2021 resulting in Final Rule for the Public Service Loan Forgiveness (PSLF) Program that were published in the Federal Register on November 1, 2022 (87 FR 65904) and continue to be codified in 34 CFR 685.219. Concurrent with these new regulations, the Department implemented the ability for the borrower and employer to digitally sign and submit the PSLF Form electronically through our Digital Platform. The PSLF form was redesigned to encourage the use of the new signature options and align the instructions on the form to mimic the user experience connected to the online submission. This new form will not be available until the regulations become effective on July 1, 2023.

US Code: 20 USC 1087(e)(m) Name of Law: Higher Education Act of 1965, as amended

Not associated with rulemaking

  88 FR 30732 05/12/2023
88 FR 61578 09/07/2023

IC Title Form No. Form Name
Application and Employment Certification for Public Service Loan Forgiveness N/A N/A

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 913,713 913,713 0 0 0 0
Annual Time Burden (Hours) 456,857 456,857 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0

Beth Grebeldinger 202 708-8242


On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

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