Information Collection Request

Indian Health Service Loan Repayment Program

ICR 202505-0917-001 · OMB 0917-0014 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0917-0014 IHS Loan Application Form and Instruction Unchanged Repair queued
LRP 60 FRN 2024.pdf Supplementary Document Uploaded 2025-05-20 Repair queued
Supporting Statement LRP Final.pdf Supporting Statement A Uploaded 2025-05-20 Available
60 day FR Publication 04-28-15 (2).pdf Supplementary Document Uploaded 2015-06-22 Repair queued
30 Day Federal Register Notice for IHS Loan Repayment Program, June 11, 2015.pdf Supplementary Document Uploaded 2015-06-22 Available
IC Document Collections
IC IDCollectionTypeStatusForm
6573 IHS Loan Application Form and Instruction Unchanged
ICR Details
0917-0014 202505-0917-001
Received in OIRA 202111-0917-001
HHS/IHS 0917-0014
Indian Health Service Loan Repayment Program
Reinstatement without change of a previously approved collection   No
Regular 05/21/2025
  Requested Previously Approved
36 Months From Approved
1,999 0
2,999 0
0 0

The Indian Health Service (IHS) Loan Repayment Program (LRP) identifies health professionals with pre-existing financial obligations for education expenses that meet program criteria and who are qualified and willing to serve at, often remote, IHS health care facilities. Under the program, eligible health professionals sign a contract under which the IHS agrees to repay part or all of their indebtedness for professional training education. In exchange, the health professionals agree to serve for a specified period of time in IHS health care facilities. This information collection covers the application process for this program.

PL: Pub.L. 94 - 437 108 Name of Law: Indian Health Care Improvement Act, as amended
  
None

Not associated with rulemaking

  89 FR 105617 12/27/2024
90 FR 11416 03/06/2025
No

1
IC Title Form No. Form Name
IHS Loan Application 0917-0014, 0917-0014, 0917-0028 Educational and Professional Background ,   Financial Information ,   General Applicant Information

  Total Request 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 1,999 0 0 0 0 1,999
Annual Time Burden (Hours) 2,999 0 0 0 0 2,999
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$268,426
No
    Yes
    No
No
No
No
No
Thomas Hamby 204 252-0331 [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.
05/21/2025