Employment Certification for Public Service Loan Forgiveness

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Employment Certification for Public Service Loan Forgiveness Form
Instructions_83C_12052011.docx Instruction
Employment Certification for Public Service Loan Forgive ECF_83C_12052011.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employment Certification for Public Service Loan Forgiveness	Agency IC Tracking Number:	4764

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 685.219

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Employment Certification for Public Service Loan Forgiveness	ECF_83C_12052011.docx		Yes	No	Paper Only
Instruction			Instructions_83C_12052011.docx		Yes	No	Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Common Services for Borrowers	FR Citation: 75 FR 59242

Number of Respondents: 2,073,643	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,073,643	2,073,643
Annual IC Time Burden (Hours)	1,036,822	1,036,822
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.