View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0915-0036	ICR Reference No: 199905-0915-001
Status: Historical Active	Previous ICR Reference No: 199809-0915-013
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/01/1999
	Date Received in OIRA: 05/05/1999
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2002	08/31/2002	06/30/1999
Responses	26,700	0	34,325
Time Burden (Hours)	4,958	0	6,000
Cost Burden (Dollars)	11,000	0	7,000

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	26,700	34,325	2,547	-10,172
Annual Time Burden (Hours)	4,958	6,000	348	-1,390
Annual Cost Burden (Dollars)	11,000	7,000	4,000	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.