PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
PS LRP Privacy Act Release Authorization Form
New
500
250
0
Form and Instruction
7
Privacy Act Release Authorization Form
Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form
New
500
250
0
Form and Instruction
6
Pediatric Specialty LRP Auth for Disc of Loan Info Form
PS LRP Employment Verification Form
New
500
250
0
Form and Instruction
8
PS LRP Employment Verification Form
Pediatric Specialty LRP Application
New
500
250
0
Form and Instruction
5
Pediatric Specialty LRP Application
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information
Modified
3200
1600
0
Form and Instruction
2
Authorization for Disclosure of Loan Information Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form
Modified
3200
1600
0
Form and Instruction
4
STAR LRP Employment Verification Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form
Modified
3200
1600
0
Form and Instruction
3
STAR LRP Privacy Act Release Authorization Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application
Modified
3200
1600
0
Form and Instruction
1
STAR LRP Program Application Content
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application
Removed
0
0
0
Form and Instruction
5
FY 2021 STAR LRP Site Application.docx
Total burden requested under this ICR:
14800
7400
0
To view an IC, click on IC Title