Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application Checklist and Self-Certification Form Removed 0 0 0 Form NELRP_006 Application Checklist and Self-Verification Form
Authorization for Release of Employment Information Form Modified 5500 550 0 Form 2 Authorization to Release Employment Information Form
Authorization to Release Information Form Modified 5500 550 0 Form 1 Authorization to Release Information Form
Instruction
Certification Of Accreditation Status for School of Nursing Education Programs Form Removed 0 0 0 Form NELRP_010 Certification Of Accreditation Status for School of Nursing Education Programs Form
Certification Regarding Debarment, Suspension, Disqualification and Related Matters Form Removed 0 0 0 Form NELRP_009 Certification Regarding Debarment, Suspension, Disqualification and Related Matters Form
Employment Verification and Critical Shortage Facility Form Removed 0 0 0 Form NELRP_003 Employment Verification and Critical Shortage Facility Form
Employment Verification for Nurse Faculty Appointment Form Removed 0 0 0 Form NELRP_004 Employment Verification for Nurse Faculty Appointment Form
Loan Information and Verification Form Removed 0 0 0 Form NELRP_2 Loan Information and Verification Form
Participant Semi-Annual Employment Verification Form Modified 4600 2300 0 Form and Instruction 4 ISV
The Nursing Education Loan Repayment Program Application Modified 5500 11000 4125 Form and Instruction 3 Application
The Verification of Acceptance or Decline of Award form Removed 0 0 0 Form NELRP_11 The Verification of Acceptance or Decline of Award form
Total burden requested under this ICR: 21100 14400 4125  
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