OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Employment Certification for Public Service Loan Forgiveness

ICR 201106-1845-002 · OMB 1845-0110 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Employment Certification for Public Service Loan Forgiveness Form New Available
Att_30-Day Supporting Statement 08052011.docx Supporting Statement A Uploaded 2011-08-08 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
198201 Employment Certification for Public Service Loan Forgiveness Form New
ICR Details
1845-0110 201106-1845-002
Historical Active
ED/FSA 4563
Employment Certification for Public Service Loan Forgiveness
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 11/02/2011
Retrieve Notice of Action (NOA) 08/12/2011
  Inventory as of this Action Requested Previously Approved
11/30/2014 36 Months From Approved
2,073,643 0 0
1,036,822 0 0
0 0 0
This form serves as the means by which eligible borrowers in the William D. Ford Federal Direct Loan Program indicate eligible employment for the purpose of final forgiveness under the Public Service Loan Forgiveness Program. The Department and its Direct Loan Program servicers will use the information collected on the Employment Certification for Public Service Loan Forgiveness form to determine whether a borrower has worked for a qualified employer during the certification period and whether payments made against a borrower's outstanding Direct Loan balance were qualifying payments for the purpose of the Public Service Loan Forgiveness (PSLF) program.
US Code: 20 USC 1087(e)(m) Name of Law: Higher Education Act of 1965, as amended
   PL: Pub.L. 110 - 84 401 Name of Law: The College Cost Reduction and Access Act of 2007
   PL: Pub.L. 110 - 315 451(b)(1)-(2) Name of Law: The HIgher Education Opportunity Act of 2008
  
None
Not associated with rulemaking
  76 FR 21337 04/15/2011
76 FR 50189 08/12/2011
Yes
1
IC Title Form No. Form Name
Employment Certification for Public Service Loan Forgiveness N/A N/A
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,073,643 0 0 2,073,643 0 0
Annual Time Burden (Hours) 1,036,822 0 0 1,036,822 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection, therefore all burden is new. This is a program change resulting in an increase in burden of 1,036,822 burden hours and 2,073,643 responses.
$1,020,000
No
No
No
No
No
Uncollected
Sandra Ninemire 202 377-3309 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/12/2011