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NFLP Due Diligence Form
Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form
OMB: 0915-0314
IC ID: 260347
OMB.report
HHS/HSA
OMB 0915-0314
ICR 202305-0915-005
IC 260347
( )
⚠️ Notice: This information collection may be referencing outdated material.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
Documents and Forms
Document Name
Document Type
Form 3
NFLP Due Diligence Form
Form and Instruction
3 NFLP Due Diligence Form
NFLP- Due-Diligence Form.pdf
Form and Instruction
3 NFLP Due Diligence Form
NFLP- Due-Diligence Form.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NFLP Due Diligence Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
3
NFLP Due Diligence Form
NFLP- Due-Diligence Form.pdf
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:
20
Number of Respondents for Small Entity:
0
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
20
0
20
0
0
0
Annual IC Time Burden (Hours)
20
0
20
0
0
0
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.