Information Collection

Application and Employment Certification for Public Service Loan Forgiveness

IC 198201 under ICR 202606-1845-004 · OMB 1845-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NA Application and Employment Certification for Public Service Loan Forgiveness	Form and Instruction
NA Application and Employment Certification for Public Service Loan Forgiveness	Form and Instruction
R_1845-0110 PSLF TEPSLF Certification and App_2026 CLEAN (1).docx studentaid.gov/pslf	Form and Instruction
R_1845-0110 PSLF TEPSLF Certification and App_2026 CLEAN (1).docx studentaid.gov/pslf	Form and Instruction

IC Title:

Application and Employment Certification for Public Service Loan Forgiveness

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA			studentaid.gov/pslf	Yes	Yes	Fillable Fileable Signable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Common Services for Borrowers

FR Citation: 91 FR 21472

Number of Respondents: 913,713

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	913,713	0	913,713
Annual IC Time Burden (Hours)	456,857	0	456,857
Annual IC Cost Burden (Dollars)	10,050,854	10,050,854	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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