Federal Register / Vol. 75, No. 248 / Tuesday, December 28, 2010 / Notices 81623 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

Periodically, the Health Resources 

and Services Administration (HRSA) 

publishes abstracts of information 

collection requests under review by the 

Office of Management and Budget 

(OMB), in compliance with the 

Paperwork Reduction Act of 1995 (44 

U.S.C. Chapter 35). To request a copy of 

the clearance requests submitted to 

OMB for review, e-mail 

paperwork@hrsa.gov or call the HRSA 

Reports Clearance Office on (301) 443– 

1129. 

The following request has been 

submitted to the Office of Management 

and Budget for review under the 

Paperwork Reduction Act of 1995: 

Proposed Project: The Nursing 

Education Loan Repayment Program 

Application (OMB No. 0915–0140)— 

Revision 

This is a request for revision of the 

Nursing Education Loan Repayment 

Program (NELRP) application and 

participant monitoring forms. The 

NELRP is authorized by 42 U.S.C. 

297n(a) (section 846(a) of the Public 

Health Service Act, as amended by 

Public Law 107–205, August 1, 2002 

and Public Law 111–148, March 23, 

2010). 

Under the NELRP, registered nurses 

and nurse faculty are offered the 

opportunity to enter into a contractual 

agreement with the Secretary to receive 

loan repayment for up to 85 percent of 

their qualifying educational loan 

balance as follows: 30 percent each year 

for the first 2 years and 25 percent for 

the optional third year. In exchange, the 

nurses agree to serve full-time for a 

minimum of 2 years as a registered 

nurse at a health care facility with a 

critical shortage of nurses or as nurse 

faculty at an eligible school of nursing. 

The NELRP forms provide information 

that is needed for selecting participants, 

repaying qualifying loans for education, 

and monitoring compliance with service 

requirements. The NELRP forms include 

the following: The NELRP Application, 

the Loan Information and Verification 

form, the Employment Verification and 

Critical Shortage Facility form, the 

Employment Verification for Nurse 

Faculty Appointment, the Authorization 

for Release of Employment Information 

form, the Authorization to Release 

Information form, the Certification 

Regarding Debarment, Suspension, 

Disqualification and Related Matters 

form, the Certification of Accreditation 

Status for School of Nursing Education 

Programs form, the NELRP Application 

Checklist and Self-Certification form, 

the Verification of Acceptance or 

Decline of Award form and the 

Participant Semi-Annual Employment 

Verification form. 

The estimates of reporting burden for 

Applicants are as follows: 

Instrument Number of 

respondents 

Responses/ 

respondents 

Total 

responses 

Hours per 

response 

Total burden 

hours 

NELRP Application .............................................................. 8,000 1 8,000 1.5 12,000 

Loan Information and Verification Form .............................. 8,000 3 24,000 1 24,000 

Employment Verification and Critical Shortage Facility 

Form ................................................................................. 7,500 1 7,500 .50 3,750 

Employment Verification for Nurse Faculty Appointment 

Form ................................................................................. 500 1 500 .25 125 

Authorization for Release of Employment Information 

Form ................................................................................. 8,000 1 8,000 .10 800 

Authorization to Release Information Form ......................... 8,000 1 8,000 .10 800 

Certification Regarding Debarment, Suspension, Disqualification and Related Matters Form ................................... 8,000 1 8,000 .10 800 

Certification Of Accreditation Status for School of Nursing 

Education Programs Form ............................................... 500 1 500 .10 50 

Application Checklist and Self-Certification Form ............... 8,000 1 8,000 .50 4,000 

The Verification of Acceptance or Decline of Award form .. 1,200 1 1,200 .25 300 

Total .............................................................................. ........................ ........................ 73,700 ........................ 46,625 

The annual estimate of burden for 

Participants is as follows: 

Participant Semi-Annual Employment Verification Form ..... 2,300 2 4,600 .5 2,300 

Total .............................................................................. 2,300 2 4,600 .5 2,300 

Written comments and 

recommendations concerning the 

proposed information collection should 

be sent within 30 days of this notice to 

the OMB desk officer for HRSA, either 

by e-mail to 

OIRA_submission@omb.eop.gov or by 

fax to 202–395–6974. Please direct all 

correspondence to the ‘‘attention of the 

OMB desk officer for HRSA.’’ 

Dated: December 21, 2010. 

Robert Hendricks, 

Director, Division of Policy and Information 

Coordination. 

[FR Doc. 2010–32561 Filed 12–27–10; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

Periodically, the Health Resources 

and Services Administration (HRSA) 


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