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Nurse Faculty Loan Program- Program Specific Data Form
Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form
OMB: 0915-0314
IC ID: 182194
OMB.report
HHS/HSA
OMB 0915-0314
ICR 202005-0915-002
IC 182194
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0314 can be found here:
2023-08-09 - No material or nonsubstantive change to a currently approved collection
2023-05-24 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Nurse Faculty Loan Program- Program Specific Data Form
Form and Instruction
1 NFLP Program Specific Data Form_7-30-2020 CLEAN.docx
NFLP Program Specific Data Form_7-30-2020 CLEAN.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Nurse Faculty Loan Program- Program Specific Data Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
NFLP Program Specific Data Form_7-30-2020 CLEAN.docx
NFLP Program Specific Data Form_7-30-2020 CLEAN.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
90
Number of Respondents for Small Entity:
90
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
90
0
-170
0
0
260
Annual IC Time Burden (Hours)
720
0
-840
0
0
1,560
Annual IC Cost Burden (Dollars)
0
0
0
0
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.