OMB control number

Indian Health Service Loan Repayment Program

OMB 0917-0014 · HHS/IHS.

OMB 0917-0014

The Indian Health Service (IHS) Loan Repayment Program (LRP) identifies health professionals with pre-existing financial obligations for education expenses that meet program criteria and who are qualified and willing to serve at, often remote, IHS health care facilities. Under the program, eligible health professionals sign a contract under which the IHS agrees to repay part or all of their indebtedness for professional training education. In exchange, the health professionals agree to serve for a specified period of time in IHS health care facilities. This information collection covers the application process for this program.

The latest form for Indian Health Service Loan Repayment Program expires 2027-10-31 and is listed under ICR 202505-0917-001.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0917-0028 General Applicant Information	Form and Instruction
Form 0917-0014 Financial Information	Form and Instruction
Form 0917-0014 Educational and Professional Background	Form and Instruction
LRP 60 FRN 2024.pdf	Supplementary Document
Supporting Statement LRP Final.pdf	Supporting Statement A
60 day FR Publication 04-28-15 (2).pdf	Supplementary Document
30 Day Federal Register Notice for IHS Loan Repayment Program, June 11, 2015.pdf	Supplementary Document
IHS Loan Application	Form and Instruction
IHS Loan Application	Form and Instruction
IHS Loan Application	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202505-0917-001	Reinstatement without change of a previously approved collection	2025-05-21
202111-0917-001	Extension without change of a currently approved collection	2021-11-08	Approved without change
201803-0917-002	Extension without change of a currently approved collection	2018-05-09	Approved without change
201506-0917-001	Extension without change of a currently approved collection	2015-06-24	Approved without change
201205-0917-001	Extension without change of a currently approved collection	2012-05-15	Approved with change
200811-0917-001	Revision of a currently approved collection	2008-11-18	Approved with change
200510-0917-002	Revision of a currently approved collection	2005-10-14	Approved with change
200211-0917-001	Extension without change of a currently approved collection	2002-11-01	Approved without change
199910-0917-001	Extension without change of a currently approved collection	1999-10-04	Approved without change
199609-0917-002	Reinstatement with change of a previously approved collection	1996-09-20	Approved without change
199212-0917-001	Revision of a currently approved collection	1992-12-11	Approved without change
199106-0917-001	New collection (Request for a new OMB Control Number)	1991-06-17	Approved without change

OMB Details

IHS Loan Application

Federal Enterprise Architecture: Education - Higher Education

Information collection instruments
Form	Name	Electronic access	Type
Form 0917-0028	General Applicant Information	www.ihs.gov/loanrepayment/applynow/	Form and instruction
Form 0917-0014	Financial Information	www.ihs.gov/loanrepayment/applynow/	Form and instruction
Form 0917-0014	Educational and Professional Background	www.ihs.gov/loanrepayment/applynow/	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.