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Federal forms, ICRs, and supporting documents

Information Collection Request

Specialty Education Loan Repayment Program (SELRP) Forms [AQ63]

ICR 201912-2900-003 · OMB 2900-0879 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form 10-XXX SELRP - Participant Agreement Form New Available
Form 10-XXX SELRP - Service Period & Loan Repayment Verification Form and Instruction New Available
Form 10-XXX SELRP - Education Loan Verification Form and Instruction New Available
Form 10-XXX SELRP - Program Status Verification Form New Repair queued
Form 10-XXX SELRP - Application Form and Instruction New Available
PRA Supp Statement A_Spec Educ Loan Repay Prog (SELRP)_AQ63_revised 2020.docx Supporting Statement A Uploaded 2020-05-06 Available
IC Document Collections
IC IDCollectionTypeStatusForm
241717 SELRP - Participant Agreement Form New
241716 SELRP - Service Period & Loan Repayment Verification Form and Instruction New
241715 SELRP - Education Loan Verification Form and Instruction New
241714 SELRP - Program Status Verification Form New
241713 SELRP - Application Form and Instruction New
ICR Details
2900-0879 201912-2900-003
Historical Inactive
VA 2900-NEW
Specialty Education Loan Repayment Program (SELRP) Forms [AQ63]
New collection (Request for a new OMB Control Number)   No
Regular
Comment filed on proposed rule 06/23/2020
Retrieve Notice of Action (NOA) 05/06/2020
Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0
Section 303 of Public Law 115-182, the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018, or the VA MISSION Act of 2018, amended title 38 of the United States Code (U.S.C.) by establishing new sections 7691 through 7697 and created a new student loan repayment program known as the Specialty Education Loan Repayment Program (SELRP). The SELRP will serve as an incentive for physicians starting or currently in residency programs in medical specialties for which VA has determined that recruitment and retention of qualified personnel is difficult to work for VA at VA facilities that need more physicians with that medical specialty. Section 303 of the VA MISSION Act of 2018 did not establish an application procedure for the SELRP. To maintain consistency in the application process of similar VA scholarship programs and to ease the implementation such programs by VA personnel, VA will mirror proposed § 17.528 to current § 17.643, Application for the Program for Repayment of Educational Loans for Certain VA Psychiatrists (PREL.) Consistent with § 17.643(a), proposed paragraph § 17.528(a) will state that a complete application for the SELRP consists of a completed application, letters of reference, and personal statement.
PL: Pub.L. 115 - 182 303 Name of Law: MISSION Act of 2018
  
None
2900-AQ63 Proposed rulemaking 84 FR 70908 12/26/2019
No
Yes
Changing Regulations
No
This is a new collection and all burden hours are considered a program increase.
$12,187
No
    Yes
    Yes
No
No
No
No
Frances O'Donnell 703 405-2449 [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.
05/06/2020