Application and Employment Certification for Public Service Loan Forgiveness

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Application and Employment Certification for Public Service Loan Forgiveness	Form and Instruction	Modified	Available
1845-0110_PSLF_83C.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-05-18	Available
OMB 83 C_PSLF_1845-0110.pdf	Supplementary Document	Uploaded 2026-05-18	Repair queued
R_1845-0110 PSLF TEPSLF Certification and App_20260514.pdf	Supplementary Document	Uploaded 2026-05-18	Available
SBPC 60 day comment FSA responses.pdf	Supplementary Document	Uploaded 2023-08-31	Repair queued
MA Att Gen 60 day comment FSA response.pdf	Supplementary Document	Uploaded 2023-08-31	Available
PSLF Comment Response Table 2.docx	Supplementary Document	Uploaded 2023-08-31	Available
1845-0110 Supporting Statement PSLF-TEPSLF Application 2023 30D 2023.docx	Supporting Statement A	Uploaded 2023-08-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
198201	Application and Employment Certification for Public Service Loan Forgiveness	Form and Instruction	Modified	NA

ICR Details

OMB Control No: 1845-0110	ICR Reference No: 202605-1845-002
Status: Historical Active	Previous ICR Reference No: 202305-1845-004
Agency/Subagency: ED/FSA	Agency Tracking No:
Title: Application and Employment Certification for Public Service Loan Forgiveness
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: 06/17/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/18/2026
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2026	12/31/2026	12/31/2026
Responses	913,713	0	913,713
Time Burden (Hours)	456,857	0	456,857
Cost Burden (Dollars)	0	0	0

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Abstract: 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.

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

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:
	88 FR 30732	05/12/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 61578	09/07/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application and Employment Certification for Public Service Loan Forgiveness	NA	NA

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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	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

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:

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Annual Cost to Federal Government: $0

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: 05/18/2026

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