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SUPPORTING STATEMENT

Information Collection for the William D. Ford Federal Direct Loan Program, Federal Family Education 

Loan Program, Federal Perkins Loan Program, and Teacher Education Assistance for College and 

Higher Education Grant Program

Discharge Application: Total and Permanent Disability

Total and Permanent Disability Discharge: Post-Discharge Monitoring

Total and Permanent Disability Discharge: Applicant Representative Designation

OMB No. 1845-0065

A. Justification

1. Explain the circumstances that make the collection of information necessary. Identify any legal or 

administrative requirements that necessitate the collection. Attach a copy of the appropriate section 

of each statute and regulation mandating or authorizing the collection of information.

The Higher Education Act of 1965, as amended (HEA), established the Federal Family Education Loan 

(FFEL) Program, the William D. Ford Federal Direct Loan (Direct Loan) Program, and the Federal Perkins 

(Perkins) Loan Program under Title IV, Parts B, D, and E, respectively. Section 437(a)(1) of the HEA 

authorizes the discharge of a borrower’s obligation to repay his or her FFEL Program loan(s) if the 

borrower is unable to engage in any substantial gainful activity by reason of any medically determinable 

physical or mental impairment that can be expected to result in death, has lasted for a continuous 

period of not less than 60 months, or can be expected to last for a continuous period of not less than 60 

months. Section 437(a)(2) of the HEA provides that a borrower who has been determined by the 

Secretary of Veterans Affairs (VA) to be unemployable due to a service-connected condition, and who 

provides documentation of that determination to the U.S. Department of Education (the Department), 

will be considered to be totally and permanently disabled for purposes of discharging the borrower’s 

FFEL Program loans, and may not be required to provided additional documentation for loan discharge 

purposes. Section 455(a)(1) of the HEA extends these loan discharge provisions to Direct Loan Program 

borrowers, and section 464(c)(1)(F) of the HEA authorizes total and permanent disability (TPD) loan 

discharges in the Perkins Loan Program, in accordance with the same eligibility requirements described 

in section 437(a)(1) and (2) of the HEA. 

The regulations related to TPD loan discharges are contained in 34 CFR 682.402(c) for the FFEL Program, 

in 34 CFR 685.212 and 34 CFR 685.213 for the Direct Loan Program, and in 34 CFR 674.61(b) for the 

Perkins Loan Program. These regulations require borrowers who seek disability discharges of their FFEL, 

Direct Loan, or Perkins loans to provide the Department with certain information in writing. The 

Discharge Application: Total and Permanent Disability (TPD Discharge Application) is the means by which 

a borrower who seeks a total and permanent disability loan discharge provides this information, which is 

required to determine the borrower’s eligibility for loan discharge. 

For the Teacher Education Assistance for College and Higher Education (TEACH) Grant Program,

regulations at 34 CFR 686.42(b) provide that a TEACH Grant recipient’s teaching service obligation is 

discharged if the recipient is totally and permanent disabled in accordance with the same definition that 

applies to borrowers in the FFEL, Direct Loan, and Perkins Loan programs, and if the recipient satisfies 

the eligibility requirements for a TPD discharge in 34 CFR 685.213. A totally and permanently disabled 

TEACH Grant recipient applies for a discharge of his or her TEACH Grant service obligation by submitting 
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a completed TPD Discharge Application to the Department. 

The Department is requesting a revision of the currently approved collection and is also requesting

approval two new forms associated with the TPD discharge process. Final regulations published on 

November 1, 2012 (77 FR 66088) made a number of substantive changes to the process for discharging 

FFEL, Direct Loan, and Perkins Loan program loans due to the borrower’s total and permanent disability 

(and, by extension, the process for discharging a TEACH Grant service obligation due to the grant 

recipient’s total and permanent disability). These changes are effective July 1, 2013. Most significantly, 

the final regulations: (1) modify the discharge process so that all discharge applicants will submit the 

TPD Discharge Application directly to the Department, instead of to the loan holder, as under the 

current regulations; and (2) specify that an applicant may demonstrate that he or she is totally and 

permanently disabled as described in §437(a)(1) of the HEA by providing the Department with copy of a 

Social Security Administration (SSA) notice of award for Social Security Disability Insurance (SSDI) or 

Supplemental Security Income (SSI) benefits that indicates the individual’s next scheduled disability 

review by the SSA will be within 5 to 7 years. We have modified the currently approved TPD Discharge 

Application to reflect these changes, and have made further changes to the format and structure of the 

form in an effort to make the form easier for discharge applicants to understand and complete.

The amended TPD discharge regulations, like the current regulations, require an individual who receives 

a TPD discharge (except for veterans who receive a discharge based on a determination from the VA 

they are unemployable due to a service-connected condition) to meet certain conditions during a 3-year 

post-discharge monitoring period that begins on the date the discharge is granted. If the individual fails 

to meet these conditions, the obligation to repay the discharged loan or complete the discharged TEACH 

Grant service obligation is reinstated. One of these conditions, under both the current and amended 

regulations, is that the individual must not have annual earnings from employment that exceed the 

poverty guideline amount for a family of two, regardless of the individual’s actual family size. The 

current regulations do not specify how an individual who receives a TPD discharge provides the 

Department with documentation of his or her employment earnings (if any) during the post-discharge 

monitoring period. However, the amended regulations specify that the discharge recipient must provide 

the Department, upon request, with documentation of annual earnings from employment on a form 

approved by the Department. Based on these regulatory requirements, we have developed and are 

requesting approval of a new form (Total and Permanent Disability: Post-Discharge Monitoring) to be 

used by TPD discharge recipients as described in Item 2 of this Supporting Statement. 

The amended TPD discharge regulations specify that a TPD discharge applicant may designate a

representative to act on the applicant’s behalf in connection with the discharge application, including 

applying for the discharge, providing notifications or information to the Department, and receiving 

notifications from the Department. To reflect this regulatory provision, we have developed and are 

requesting approval of a second new form (Total and Permanent Disability: Applicant Representative 

Designation) that may be optionally used by discharge applicants as described in Item 2 of this 

Supporting Statement. 

A description and justification of the new data elements that have been added to the TPD Discharge 

Application, and of the data elements on the two new forms, is included at the end of this Supporting 

Statement.

2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new 

collection, indicate the actual use the agency has made of the information received from the current 
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collection.

The information collected on the TPD Discharge Application has been used by the Department to 

determine whether a borrower or TEACH Grant recipient meets the eligibility criteria for a total and 

permanent disability discharge of his or her loan(s) or TEACH Grant service obligation, and it will 

continue to be used for this purpose. 

The new TPD: Post-Discharge Monitoring form will be used by individuals who have been granted a TPD 

discharge to provide the Department with documentation of their annual earnings from employment 

during the 3-year post-discharge monitoring period, as required under the amended TPD discharge 

regulations.

The new TPD: Applicant Representative Designation form may be optionally used by a TPD discharge 

applicant to: (1) designate a representative to act on the applicant’s behalf in connection with the 

applicant’s discharge request; (2) change a previously designated representative; or (3) revoke a 

previous designation of a representative. 

3. Describe whether, and to what extent, the collection of information involves the use of automated, 

electronic, mechanical, or other technological collection techniques or forms of information 

technology, e.g. permitting electronic submission of responses, and the basis for the decision of 

adopting this means of collection. Also describe any consideration given to using technology to reduce 

burden.

This TPD Discharge Application does not involve the use of technological processes such as electronic 

submission of responses. This form requires a signature from both the discharge applicant and the 

physician who certifies the applicant’s disability. In addition, the physician must provide additional 

information (sometimes including attached documentation) related to the applicant’s disabling 

condition. The United States Postal Service, or some other mail delivery service, provides the only 

currently feasible means for loan holders to send the disability discharge application to borrowers, and 

for borrowers and TEACH Grant recipients to return the completed discharge application and any 

supporting documents. 

In some cases a discharge recipient who is completing the TPD: Post-Discharge Monitoring form will be 

required to attach documentation of employment earnings, making electronic submission of the form 

impractical. In other cases, however, the individual will simply be certifying that he or she has no 

earnings from employment. The Department intends to explore options for allowing electronic 

completion and submission of the TPD: Post-Discharge Monitoring form in the latter situation. The 

Department will also explore options for allowing electronic completion and submission of the TPD: 

Borrower Representative Designation form.

To reduce burden on discharge recipients, the Department also intends to explore with the SSA the 

possibility of eventually establishing a process that would provide for an electronic exchange of 

information related to a discharge applicant’s annual employment earnings.

4. Describe efforts to identify duplication. Show specifically why any similar information already 

available cannot be used or modified for use for the purposes described in Item 2 above

A review of procedures indicates that current requirements avoid duplication. There is no information 

available from other sources that can be used to determine a borrower’s or TEACH Grant recipient’s 
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eligibility for a total and permanent disability discharge, nor is there any current means of documenting, 

from other sources, a discharge recipient’s annual employment earnings during the post-discharge 

monitoring period.

5. If the collection of information impacts small businesses or other small entities (Item 8b of IC Data 

Part 2), describe any methods used to minimize burden.

No small businesses are affected by this information collection.

6. Describe the consequences to Federal program or policy activities if the collection is not conducted 

or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

If a borrower or TEACH Grant recipient did not complete the TPD Discharge Application and the TPD: 

Post-Discharge Monitoring form, the Department would not have the information needed to determine 

whether the individual meets the eligibility requirements for a total and permanent disability discharge. 

A borrower or TEACH Grant recipient will be required to complete a discharge application only one time.

The amended regulations reduce burden on discharge applicants by requiring an individual to submit

just one discharge application to the Department to apply for discharge of all of the individual’s FFEL, 

Direct Loan, and Perkins Loan program loans, as well as any TEACH Grant service obligations. 

7. Explain any special circumstances that would cause an information collection to be conducted in a 

manner:

 Requiring respondents to report information to the agency more often than quarterly;

 Requiring respondents to prepare a written response to a collection of information in fewer 

than 30 days after receipt of it;

 Requiring respondents to submit more than an original and two copies of any document;

 Requiring respondents to retain records, other than health, medical, government contract, 

grant-in-aid, or tax records for more than three years;

 In connection with a statistical survey, that is not designed to produce valid and reliable 

results than can be generalized to the universe of study;

 Requiring the use of a statistical data classification that has not been reviewed and approved 

by OMB;

 That includes a pledge of confidentiality that is not supported by authority established in 

statute or regulation, that is not supported by disclosure and data security policies that are 

consistent with the pledge, or that unnecessarily impedes sharing of data with other agencies 

for compatible confidential use; or

 Requiring respondents to submit proprietary trade secrets, or other confidential information 

unless the agency can demonstrate that it has instituted procedures to protect the 

information’s confidentiality to the extent permitted by law.

The collection of this information will be conducted in a manner that does not involve any of the above 

conditions. 
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8. If applicable, provide a copy and identify the date and page number of publication in the Federal 

Register of the agency’s notice, required by 5 CFR 1320.8(d), soliciting comments on the information 

collection prior to submission to OMB. Summarize public comments received in response to that 

notice and describe actions taken by the agency in response to these comments. Specifically address 

comments received on cost and hour burden.

Describe efforts to consult with persons outside the agency to obtain their views on the availability of 

data, frequency of collection, the clarity of instruction and record keeping, disclosure, or reporting 

format (if any), and on the data elements to be recorded, disclosed, or reported.

Consultation with representatives of those from whom information is to be obtained or those who 

must compile records should occur at least once every 3 years – even if the collection of information 

activity is the same as in prior periods. There may be circumstances that may preclude consultation in 

a specific situation. These circumstances should be explained.

In developing the revised TPD Discharge Application and the two new forms included with this 

submission, the Department solicited recommendations from groups representing the student financial 

aid industry and borrowers. The forms included with this submission incorporate some of the 

recommendations submitted by these groups. Notices will be published in the Federal Register providing 

the public with 60- and 30-day periods for submitting comments on the forms.

9. Explain any decision to provide any payment or gift to respondents, other than remuneration of 

contractors or grantees.

No payments or gifts will be provided to respondents.

10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance 

in statute, regulation, or agency policy.

Each form includes a Privacy Act Notice that (1) informs the discharge applicant of the statutory 

authority for the information collection, (2) explains that disclosure of the information is voluntary, but 

is required in order to determine the applicant’s eligibility for a discharge, and (3) identifies the third 

parties to whom the information may be disclosed, and explains the circumstances under which such 

disclosures may occur.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and 

attitudes, religious beliefs, and other matters that are commonly considered private. The justification 

should include the reasons why the agency considers the questions necessary, the specific uses to be 

made of the information, the explanation to be given to persons from whom the information is 

requested, and any steps to be taken to obtain their consent.

The TPD Discharge Application requires the physician who completes the physician’s certification section 

to provide information about the applicant’s disabling condition. This information may be considered 

sensitive, but it is needed for the Department to determine whether a borrower or TEACH Grant 

recipient meets the statutory definition of totally and permanently disabled.

12. Provide estimates of the hour burden of the collection of information. The statement should :

 Indicate the number of respondents, frequency of response, annual hour burden, and an 

explanation of how the burden was estimated. Unless directed to do so, agencies should 
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not conduct special surveys to obtain information on which to base hour burden 

estimates. Consultation with a sample (fewer than 10) of potential respondents is 

desirable. If the hour burden on respondents is expected to vary widely because of 

differences in activity, size, or complexity, show the range of estimated hour burden, and 

explain the reasons for the variance. Generally, estimates should not include burden hours 

for customary and usual business practices.

 If this request for approval covers more than one form, provide separate hour burden 

estimates for each form and aggregate the hour burdens in item 16 of IC Data Part 1.

 Provide estimates of annualized cost to respondents of the hour burdens for collections of 

information, identifying and using appropriate wage rate categories. The cost of 

contracting out or paying outside parties for information collection activities should not be 

included here. Instead, this cost should be included in Item 14.

The total estimated annual reporting hour burden for this information collection is approximately 

127,400 hours. The burden estimate for this collection was calculated as follows:

TPD Discharge Application

Estimated annual number of respondents: 86,400

Number of responses per applicant: x 1

Hours per response: x 0.5 (30 minutes)

Annual hour burden: 43,200 hours

TPD: Post-Discharge Monitoring Form

Estimated annual number of respondents: 160,000

Number of responses per discharge recipient: x 1

Hours per response: x 0.5 (30 minutes)

Annual hour burden: 80,000 hours

TPD: Applicant Representative Designation

Estimated annual number of respondents: 8,400

Number of responses per discharge recipient: x 1

Hours per response: x 0.5 (30 minutes)

Annual hour burden: 4,200 hours
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13. Provide an estimate of the total annual cost burden to respondents or record keepers resulting 

from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 

14.)

 The cost estimate should be split into two components: (a) a total capital and start-up cost 

component (annualized over its expected useful life); and (b) a total operation and 

maintenance and purchase of services component. The estimates should take into account 

costs associated with generating, maintaining, and disclosing or providing the information. 

Include descriptions of methods used to estimate major cost factors including system and 

technology acquisition, expected useful life of capital equipment, the discount rate(s), and the 

time period over which costs will be incurred. Capital and start-up costs include, among other 

items, preparations for collecting information such as purchasing computers and software; 

monitoring, sampling, drilling and testing equipment; and acquiring and maintaining record 

storage facilities.

 If cost estimates are expected to vary widely, agencies should present ranges of cost burdens 

and explain the reasons for the variance. The cost of contracting out information collection 

services should be a part of this cost burden estimate. In developing cost burden estimates, 

agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day preOMB submission public comment process and use existing economic or regulatory impact 

analysis associated with the rulemaking containing the information collection, as appropriate.

 Generally, estimates should not include purchases of equipment or services, or portions 

thereof, made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with 

requirements not associated with the information collection, (3) for reasons other than to 

provide information or keep records for the government, or (4) as part of customary and usual 

business or private practices.

Total Annualized Capital/Startup Cost: 0

Total Annual Costs (O&M): 0

 ______

Total Annualized Costs Requested: 0

There are no capital/startup costs to respondents, nor are there any annual costs to respondents 

associated with operating or maintaining systems or purchasing services.

There is an estimated annual cost to respondents of $117,208.00 associated with postage. This estimate 

was calculated by multiplying the estimated number of respondents (254,800) by the cost of postage 

required to return a discharge application, post-discharge monitoring form, or applicant representative 

designation form ($0.46).

14. Provide estimates of annualized cost to the Federal government. Also, provide a description of the 

method used to estimate cost, which should include quantification of hours, operational expenses 

(such as equipment, overhead, printing, and support staff), and any other expense that would not 

have been incurred without this collection of information. Agencies also may aggregate cost estimates 

from Items 12, 13, and 14 in a single table.
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There is no significant annualized cost to the Federal government. The Department’s contracts with its 

federal servicers, including the servicer that handles TPD discharge processing, is not based on a fee-forservice model; rather, the Department pays its servicers based on performance metrics. 

15. Explain the reasons for any program changes or adjustments to #16f of the IC Data Part 1 Form.

We are reporting a program change of 88,205 hours. This increase is attributable to additional burden 

associated with the two new forms (TPD: Post-Discharge Monitoring and TPD: Applicant Representative 

Designation) that are required as a result of the changes to the TPD discharge regulations.

16. For collections of information whose results will be published, outline plans for tabulation and 

publication. Address any complex analytical techniques that will be used. Provide the time schedule 

for the entire project, including beginning and ending dates of the collection of information, 

completion of report, publication dates, and other actions.

The results of this information collection will not be published.

17. If seeking approval to not display the expiration date for OMB approval of the information 

collection, explain the reasons that display would be inappropriate.

The Department is not seeking this approval.

18. Explain each exception to the certification statement identified in the Certification of Paperwork 

Reduction Act.

The Department is not requesting any exceptions to the Certification for Paperwork Reduction Act 

Submissions.

B. Collection of Information Employing Statistical Methods

This collection of information will not employ any statistical methods.
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JUSTIFICATION OF DATA ELEMENTS

TPD DISCHARGE APPLICATION (ONLY NEW DATA ELEMENTS ARE LISTED)

Data Element Purpose

Section 2, Item 1: Yes/No checkboxes for the 

applicant to indicate whether he/she is a veteran 

who has received a determination from the VA 

that he/she is unemployable due to a serviceconnected disability.

To facilitate completion of the discharge 

application. An applicant who checks Yes is 

informed that he/she must attach the appropriate 

documentation from the VA and is not required to 

have a physician complete Section 4 of the 

application. An applicant who checks No is 

instructed to go to Item 2.

Section 2, Item 2: Yes/No checkboxes for the 

applicant to indicate whether he/she has received 

an SSA notice of award for SSDI or SSI benefits 

stating that the applicant’s next scheduled 

disability review will be within 5 to 7 years.

To facilitate completion of the discharge 

application. An applicant who checks Yes is 

informed that he/she must attach the appropriate 

SSA documentation is not required to have a 

physician complete Section 4 of the application. An 

applicant who checks No is instructed to have a 

physician complete Section 4.

TPD: POST-DISCHARGE MONITORING FORM

Data Element Purpose

Section 1: Applicant SSN, DOB, Name, Address, 

Telephone, E-mail address, and check box for 

applicant to indicate if any information has 

changed (these items must be completed only if 

pre-printed information is incomplete or has 

changed).

To identify the discharge applicant and enable the 

Department’s total and disability discharge 

servicer to contact the applicant.

Section 2, Item 1: Date fields (mm/dd/yyyy) to 

identify period for which applicant must provide 

documentation of earnings from employment. 

These dates will be entered by the Department’s 

total and permanent disability discharge servicer.

Individuals who receive a total and permanent 

disability discharge (except for veterans who 

receive a discharge based on a determination by 

the VA that they are unemployable due to a 

service-connected disability) are subject to a 3-

year post-discharge monitoring period during 

which they must provide the Department with 

documentation of their annual earnings from 

employment. These dates (which will be entered 

on the form by the Department’s total and 

permanent disability servicer before the form is 

provided to the discharge recipient) will identify 
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the 12-month period for which the discharge 

recipient must provide documentation of 

employment earnings.

Section 2, Item 2: Yes/No check boxes for the 

discharge recipient to indicate whether he or she 

received income from employment during the 

period identified in Item 1. If Yes, the individual 

must provide documentation of earnings as 

described under Acceptable Documentation. If No, 

the individual certifies, by signing the form, that 

he/she had no income from employment during 

the listed period. 

To enable the Department’s total and permanent 

disability discharge servicer to determine whether 

the discharge recipient is meeting one of the 

regulatory requirements of the 3-year postdischarge monitoring period. During this period a 

discharge recipient must not have earnings from 

employment that exceed the poverty guideline 

amounts for a family of 2 in the individual’s state. 

If a discharge recipient has annual employment 

earnings in excess of this amount during the 3-year 

post-discharge monitoring period, the Department 

reinstates the individual’s discharged loan(s) 

and/or TEACH Grant service obligation.

Section 3: Discharge recipient’s (or 

representative’s) signature, printed name, and 

date. 

By signing, the discharge recipient (or the 

individual’s representative) certifies that all 

information on the form and in any accompanying 

documentation is true, complete, and correct, and 

further certifies that he or she understands the 

conditions under which discharged loans and/or 

TEACH Grant service obligations may be reinstated 

during the 3-year post-discharge monitoring 

period. 

TPD DISCHARGE: APPLICANT REPRESENTATIVE DESIGNATION

Data Element Purpose

Section 1: Applicant SSN, DOB, Name, Address, 

Telephone, E-mail address, and check box for 

applicant to indicate if any information has 

changed (these items must be completed only if 

pre-printed information is incomplete or has 

changed).

To identify the discharge applicant and enable the 

Department’s total and disability discharge 

servicer to contact the applicant.

Section 2, Item 1: Three check boxes (a, b, and c) 

for the applicant to indicate whether he or she is 

designating a representative, changing a 

previously designated representative, or revoking 

a previous designation.

To identify the purpose for which the applicant is 

completing the form.

Section 2, Item 2: Representative’s name, address, To identify the representative designated by the
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telephone, and e-mail address. applicant and provide contact information for that 

individual or organization.

Section 3: Applicant’s and representative’s 

signatures and dates.

By signing, the applicant requests to designate, 

change, or revoke a representative, and authorizes 

release of information related to the applicant’s 

discharge request to the representative. The 

signatures of both the applicant and 

representative confirm their understanding of the 

terms and conditions that apply when a 

representative is designated and certify that all 

information provided on the form is correct.