### 1 **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 collec tion of information necessary.**  **Identify any legal or administrative requirements th**  **at 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 borrowe r is unable to engage in any substantial gainful activity by reason of any medically deter minable 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 provid es 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 disc harge provision s 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 43 7(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. Th ese 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 Applicatio n) is the means by which a borrower who seeks a total and permanent disability loan disc harge 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 th e 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 fin al 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 Insur ance (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 a mended 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 specif y 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 requirement s, 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) t hat may be optionally used by discharge applicant s as described in Item 2 of this Supporting St atement. 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 Appl ication 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 auto**  **mated, 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 adop** **ting this means of collection. Also describe any consi**  **deration 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 disab ling 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. I n 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 submiss ion of the form impractical . I n 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

- Disc harge 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 in tends 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 ef** **forts 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 disc harge 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 b urden.**  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 require ments 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:** 

 **R equiring respondents to report information to the agency more often than quarterly;** 

 **R equiring respondents to prepare a written response to a collection of information in fewer**  **than 30 days after receipt of it;** 

 **R equiring respondents to submit more than an original and two copies of any document;** 

 **R equiring respondents to retain records, other than health, medical, government contract,**  **grant -**  **in -** **aid, or tax records for more than three years;**

 **I n connection wi** **th a statistical survey, that is not designed to produce valid and reliable results than can be generalized to the universe of study;** 

 **R equiring the use of a statistical data classification that has not been reviewed and approved**  **by OMB;**

 **T hat includes a ple**  **dge 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 age ncies**  **for compatible confidential use; or**

 **R equiring 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 t he agency’s notice, required by 5 CFR 1320.8(d), soliciting comments on the information**  **collecti on 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 comme**  **nts. 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, disc**  **losure, 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 y** **ears –**  **even if the collection of information activity is**  **the same as in prior periods. There may be circumstances that may preclude consult** **ation in a specific situation.**  **These circumstances should be explained.** In developing the revised TPD Discharge Appli cation 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 wi th 60

- and 30

- day periods for submitting comments on the form s . **9. Explain any decision to provide any payment or gift to respo**  **ndents, 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 natur** **e, such as sexual behavior and attitudes, religious beliefs, and other matters that ar** **e commonly considered private. The justification**  **should include the reasons why the agency considers the questions necessary, the specific uses to be made of the informat**  **ion, 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 infor mation 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** 

### 6 **not conduct special surveys to obtain information on which to base hour burden est**  **imates. Consultation with a sample (fewer than 10) of poten tial 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 ex**  **plain 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 app**  **ropriate wage rate categories. The cost of**  **contracting out or paying outside par ties 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 hou rs

**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 p**  **urchase 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**  **sto rage 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 pre** 
**** **OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rule**  **making 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 as sociated 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 c** **ost 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 t**  **his 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 s ignificant annualized c ost 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

-for

service model; rather, the Department pays its servicers ba sed 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 ta**  **bulation 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 ot**  **her 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 Departmen t 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.

### 9 **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 unem ployable due to a service

connected disability. To facilitate completion of the discharg e 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 compl etion 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 hav e 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: D ate 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 disa bility 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 D epartment 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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- m onth 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 i n 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 De partment’s total and permanent disability discharge servicer to determine whether the discharge recipient is meeting one of the regulatory requirements of the 3

-year post
discharge 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 e arnings 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, pri nted 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 ena ble 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 tha t all information provided on the form is correct.