Application and Employment Certification for Public Service Loan Forgiveness

ICR 202001-1845-007 · OMB 1845-0110 · Active

⚠️ Notice: This information collection may be outdated.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

Forms and Documents

Document	Type	Status	Availability
Application and Employment Certification for Public Service Loan Forgiveness Form	Form and Instruction	Modified	Available
FedLoan Servicing Comments - Appl and Empl Cert for PSLF 5.14.2020 FSA response 20200811.docx	Supplementary Document	Uploaded 2020-08-11	Repair queued
PSLFFormComments.docx	Supplementary Document	Uploaded 2020-04-10	Repair queued
1845-0110 Supporting Statement post 30D OMB 7.2020 FSA response 20200811 no comments.docx	Supporting Statement A	Uploaded 2020-08-11	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
198201	Application and Employment Certification for Public Service Loan Forgiveness Form	Form and Instruction	Modified

ICR Details

OMB Control No: 1845-0110	ICR Reference No: 202001-1845-007
Status: Active	Previous ICR Reference No: 201612-1845-006
Agency/Subagency: ED/FSA	Agency Tracking No:
Title: Application and Employment Certification for Public Service Loan Forgiveness
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/11/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/15/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	36 Months From Approved	08/31/2020
Responses	801,261	0	728,419
Time Burden (Hours)	400,631	0	364,210
Cost Burden (Dollars)	0	0	0

Abstract: The Department is consolidating the forms that borrowers must complete if they want to ultimately receive the Public Service Loan Forgiveness (PSLF) & Temporary Expanded PLSF (TESPLF). There will now be a single form for these programs. The form is being renamed the Public Service Loan Forgiveness (PSLF) & Temporary Expanded PLSF (TESPLF) Certification and Application. This revised form includes the Employment Certification Form which is already part of this collection. This consolidation of forms will remove the need for borrowers to separately complete the PSLF application and submit a separate email for the TEPSLF program. This combining will also aid the Department in streamlining the forgiveness determination process.

Authorizing Statute(s): US Code: 20 USC 1087(e)(m) Name of Law: Higher Education Act of 1965, as amended

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 5405	01/30/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 20992	04/15/2020
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application and Employment Certification for Public Service Loan Forgiveness Form	N/A	N/A

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	801,261	728,419	72,842
Annual Time Burden (Hours)	400,631	364,210	36,421
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a program change of the revision that represents an increase of 36,421 burden hours due to the result of a new combined form for borrowers to submit for employment considerations and to have TEPSLF eligibility.

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Beth Grebeldinger 202 708-8242

Common Form ICR: No