National Institutes of Health Loan Repayment Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 4 NIH LRP Coordinators	Form and Instruction	Unchanged	Available
Form 4 NIH LRP Coordinators	Form and Instruction	Unchanged	Repair queued
Form 3 Institutional Business Officer (IBO)	Form and Instruction	Unchanged	Available
Form 3 Institutional Business Officers (IBO)	Form and Instruction	Unchanged	Repair queued
Form 2 Recommenders	Form and Instruction	Unchanged	Available
Form 2 Recommenders	Form and Instruction	Unchanged	Repair queued
Form 1 Applicant	Form and Instruction	Unchanged	Available
Form 1 Renewal Intramural Applicants	Form and Instruction	Unchanged	Repair queued
Form 1 Applicant	Form and Instruction	Unchanged	Available
Form 1 Initial Intramural Applicants	Form and Instruction	Unchanged	Repair queued
Form 1 Applicant	Form and Instruction	Unchanged	Available
Form 1 Renewal Extramural Applicants	Form and Instruction	Unchanged	Repair queued
Form 1 Personal Information Page (revised)	Form	Modified	Available
Form 1 Applicant	Form and Instruction	Modified	Available
Form 1 Initital Extramural Applicants	Form and Instruction	Modified	Repair queued
Personal Information NIH 2674-1 track changes.pdf	Supplementary Document	Uploaded 2025-05-21	Available
Personal Information NIH 2674-1 track changes.pdf	Supplementary Document	Uploaded 2025-05-21	Repair queued
OMB Change Request Memo - LRP 03-24-2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-21	Repair queued
OMB Change Request Memo - LRP 03-24-2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-21	Repair queued
HHS Approved - LRP Privacy Impact Assessment 2022.03.04.pdf	Supplementary Document	Uploaded 2022-08-31	Repair queued
HHS Approved - LRP Privacy Impact Assessment 2022.03.04.pdf	Supplementary Document	Uploaded 2022-08-31	Repair queued
pub 30-day FRN2022-18592.pdf	Supplementary Document	Uploaded 2022-08-30	Available
pub 30-day FRN2022-18592.pdf	Supplementary Document	Uploaded 2022-08-30	Repair queued
Loan Repayment Supporting Statement A_07_25_2022.docx	Supporting Statement A	Uploaded 2022-08-30	Available
Loan Repayment Supporting Statement A_07_25_2022.docx	Supporting Statement A	Uploaded 2022-08-30	Repair queued
Eligibilty - HD with burden statement.pdf	Supplementary Document	Uploaded 2019-08-06	Available
Eligibilty - HD with burden statement.pdf	Supplementary Document	Uploaded 2019-08-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
237390	NIH LRP Coordinators	Form and Instruction	Unchanged	NIH LRP Coordinators
237390	NIH LRP Coordinators	Form and Instruction	Unchanged
237389	Institutional Business Officers (IBO)	Form and Instruction	Unchanged	Institutional Business Officer (IBO)
237389	Institutional Business Officers (IBO)	Form and Instruction	Unchanged
237387	Recommenders	Form and Instruction	Unchanged	Recommenders
237387	Recommenders	Form and Instruction	Unchanged
237384	Renewal Intramural Applicants	Form and Instruction	Unchanged	Applicant
237384	Renewal Intramural Applicants	Form and Instruction	Unchanged
237383	Initial Intramural Applicants	Form and Instruction	Unchanged	Applicant
237383	Initial Intramural Applicants	Form and Instruction	Unchanged
237382	Renewal Extramural Applicants	Form and Instruction	Unchanged	Applicant
237382	Renewal Extramural Applicants	Form and Instruction	Unchanged
237381	Initital Extramural Applicants	Form	Modified	Personal Information Page (revised)
237381	Initital Extramural Applicants	Form and Instruction	Modified	Applicant
237381	Initital Extramural Applicants	Form and Instruction	Modified

ICR Details

OMB Control No: 0925-0361	ICR Reference No: 202505-0925-002
Status: Historical Active	Previous ICR Reference No: 202208-0925-004
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: National Institutes of Health Loan Repayment Programs
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/02/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/28/2025
Terms of Clearance: This ICR Change to comply with EO 14168 (Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government) has been approved.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2026	01/31/2026	01/31/2026
Responses	14,120	0	14,120
Time Burden (Hours)	23,952	0	23,952
Cost Burden (Dollars)	0	0	0

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Abstract: The NIH Loan Repayment Programs (LRPs) are designed to attract highly qualified physicians and other scientific or medical personnel to research opportunities at the National Institutes of Health (NIH, Intramural) and non-NIH sites (Extramural). Currently, there are three Intramural and six Extramural subcategories. Intramural subcategories include AIDS Research, Clinical Research for Individuals from Disadvantaged Backgrounds, and General Research. Extramural subcategories include Clinical Research, Pediatric Research, Contraception and Infertility Research, Health Disparities Research, Clinical Research for Individuals from Disadvantaged Backgrounds, and Research in Emerging Areas Critical to Human Health. Data collected through application forms is necessary to determine an applicant’s eligibility for the program, including the applicant’s research plans and career interests.

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Authorizing Statute(s): US Code: 42 USC 288-1 Name of Law: AIDS Research loan Repayment Program
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 31896	05/25/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 52981	08/30/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Initial Intramural Applicants	1	Applicant
Initital Extramural Applicants	1, 1	Applicant ,   Personal Information Page (revised)
Institutional Business Officers (IBO)	3	Institutional Business Officer (IBO)
NIH LRP Coordinators	4	NIH LRP Coordinators
Recommenders	2	Recommenders
Renewal Extramural Applicants	1	Applicant
Renewal Intramural Applicants	1	Applicant

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	14,120	14,120	0	0	0	0
Annual Time Burden (Hours)	23,952	23,952	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Although the formatting of the forms may appear different due to the ASSIST module, there are no changes to the collection instruments themselves (in other words, the changes are only aesthetic). Due to workflow efficiencies realized through the ASSIST module along with a reduction in annual application submissions, we estimate a reduction of 3,529 burden hours since the previously approved submission.

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Annual Cost to Federal Government: $2,131,777

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/28/2025

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