1482 Federal Register / Vol. 90, No. 5 / Wednesday, January 8, 2025 / Notices 

the Office of Agreements at (202) 523– 

5793 or tradeanalysis@fmc.gov. 

Agreement No.: 201347–001. 

Agreement Name: Sallaum/Hyundai 

Glovis Space Charter Agreement. 

Parties: Hyundai Glovis Co. Ltd.; 

Sallaum Lines SA. 

Filing Party: Wayne Rohde, Cozen 

O’Connor. 

Synopsis: The amendment expands 

the geographic scope of the Agreement, 

clarifies language in light of the 

expansion of the scope, and adds new 

Articles 5.1(b) and 5.1(c). 

Proposed Effective Date: 1/3/2025. 

Location: https://www2.fmc.gov/ 

FMC.Agreements.Web/Public/ 

AgreementHistory/33505. 

Dated: January 3, 2025. 

Alanna Beck, 

Federal Register Alternate Liaison Officer. 

[FR Doc. 2025–00229 Filed 1–7–25; 8:45 am] 

BILLING CODE 6730–02–P 

FEDERAL MINE SAFETY AND HEALTH 

REVIEW COMMISSION 

Sunshine Act Meetings 

TIME AND DATE: 2 p.m., Tuesday, January 

28, 2025. 

PLACE: The Richard V. Backley Hearing 

Room, Room 511, 1331 Pennsylvania 

Avenue NW, Suite 504 North, 

Washington, DC 20004 (enter from F 

Street entrance). 

STATUS: Open. 

MATTERS TO BE CONSIDERED: The 

Commission will consider and act upon 

the following in open session: Secretary 

of Labor v. Morton Salt, Inc., Docket No. 

CENT 2022–0176. (Issues include 

whether the Judge erred in concluding 

that violations of 30 CFR 57.3200 and 

57.11053(c) were not significant and 

substantial.) 

Any person attending this meeting 

who requires special accessibility 

features and/or auxiliary aids, such as 

sign language interpreters, must inform 

the Commission in advance of those 

needs. Subject to 29 CFR 2706.150(a)(3) 

and 2706.160(d). 

CONTACT PERSON FOR MORE INFORMATION: 

Emogene Johnson (202) 434–9935/(202) 

708–9300 for TDD Relay/1–800–877– 

8339 for toll free. 

Phone Number for Listening to 

Meeting: 1–(866) 236–7472. 

Passcode: 678–100. 

Authority: 5 U.S.C. 552b. 

Dated: January 6, 2025. 

Sarah L. Stewart, 

Deputy General Counsel. 

[FR Doc. 2025–00360 Filed 1–6–25; 4:15 pm] 

BILLING CODE 6735–01–P 

FEDERAL MINE SAFETY AND HEALTH 

REVIEW COMMISSION 

Sunshine Act Meetings 

TIME AND DATE: 10 a.m., Tuesday, 

January 28, 2025. 

PLACE: The Richard V. Backley Hearing 

Room, Room 511, 1331 Pennsylvania 

Avenue NW, Suite 504 North, 

Washington, DC 20004 (enter from F 

Street entrance). 

STATUS: Open. 

MATTERS TO BE CONSIDERED: The 

Commission will hear oral argument in 

the matter Secretary of Labor v. Morton 

Salt, Inc., Docket No. CENT 2022–0176. 

(Issues include whether the Judge erred 

in concluding that violations of 30 CFR 

57.3200 and 57.11053(c) were not 

significant and substantial.) 

Any person attending this meeting 

who requires special accessibility 

features and/or auxiliary aids, such as 

sign language interpreters, must inform 

the Commission in advance of those 

needs. Subject to 29 CFR 2706.150(a)(3) 

and 2706.160(d). 

CONTACT PERSON FOR MORE INFORMATION: 

Emogene Johnson (202) 434–9935/(202) 

708–9300 for TDD Relay/1–800–877– 

8339 for toll free. 

Phone Number for Listening to 

Meeting: 1–(866) 236–7472. 

Passcode: 678–100. 

Authority: 5 U.S.C. 552b. 

Dated: January 6, 2025. 

Sarah L. Stewart, 

Deputy General Counsel. 

[FR Doc. 2025–00365 Filed 1–6–25; 4:15 pm] 

BILLING CODE 6735–01–P 

GENERAL SERVICES 

ADMINISTRATION 

[OMB Control No. 3090–XXXX; Docket No. 

2025–0001; Sequence No. 2] 

Information Collection; Student Loan 

Repayment Application and Service 

Agreement (GSA Form 5015) 

AGENCY: Office of Human Resource 

Management, Strategic Planning, Policy, 

and Training Division, General Services 

Administration (GSA). 

ACTION: Notice; request for comments. 

SUMMARY: Under the provisions of the 

Paperwork Reduction Act, the 

Regulatory Secretariat Division will be 

submitting to the Office of Management 

and Budget (OMB) a request to review 

and approve a new information 

collection requirement. 

DATES: Submit comments on or before 

March 10, 2025. 

ADDRESSES: Submit comments 

identified by Information Collection 

3090–XXXX; ‘‘Student Loan Repayment 

Application and Service Agreement 

(GSA Form 5015)’’ to: http://

www.regulations.gov. Submit comments 

via the Federal eRulemaking portal by 

searching for ‘‘Information Collection 

3090–XXXX; ‘‘Student Loan Repayment 

Application and Service Agreement 

(GSA Form 5015).’’ Select the link 

‘‘Submit a Comment’’ that corresponds 

with ‘‘Information Collection 3090– 

XXXX; Student Loan Repayment 

Application and Service Agreement 

(GSA Form 5015).’’ Follow the 

instructions provided at the ‘‘Submit a 

Comment’’ screen. Please include your 

name, company name (if any), and 

‘‘Information Collection 3090–XXXX; 

Student Loan Repayment Application 

and Service Agreement (GSA Form 

5015)’’ on your attached document. If 

your comment cannot be submitted 

using https://www.regulations.gov, call 

or email the points of contact in the FOR

FURTHER INFORMATION CONTACT section of 

this document for alternate instructions. 

Instructions: Please submit comments 

only and cite ‘‘Information Collection 

3090–XXXX; Student Loan Repayment 

Application and Service Agreement 

(GSA Form 5015),’’ in all 

correspondence related to this 

collection. Comments received generally 

will be posted without change to http:// 

www.regulations.gov, including any 

personal and/or business confidential 

information provided. To confirm 

receipt of your comment(s), please 

check www.regulations.gov, 

approximately two-to-three days after 

submission to verify posting. 

FOR FURTHER INFORMATION CONTACT: 

Colin C. Bennett, Human Resources 

Specialist, Office of Human Resources 

Management, Strategic Planning, Policy, 

and Training Division, at telephone 

240–418–6822 or via email to 

colin.bennett@gsa.gov for clarification of 

content. 

SUPPLEMENTARY INFORMATION: 

A. Purpose 

Federal civil service personnel law, 

codified at 5 U.S.C. 5379, allows Federal 

agencies to use appropriated funds, 

revenue funds, or revolving funds, to 

pay for all or part of student loan debts 

incurred by job candidates or existing 

agency employees. By law, each 

candidate or employee is limited to a 

benefit of $10,000 per calendar year and 

a lifetime limit of $60,000 (at any 

agency or combination of Federal 

agencies). This benefit is paid by the 

Federal agency directly to the financial 

institution, and not to the job candidate 


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Federal Register / Vol. 90, No. 5 / Wednesday, January 8, 2025 / Notices 1483 

or employee. When paid by an agency 

to the lender, these benefits are 

considered taxable wages and are 

subject to income tax withholding and 

Social Security and Medicare payroll 

taxes. 

There are many eligibility 

requirements that must be met before 

agencies can transfer funds to a 

candidate’s or employee’s lender. First, 

the student loans must be made, 

insured, or guaranteed under parts B, D 

or E of title IV of the Higher Education 

Act of 1965 (20 U.S.C. 1071 et seq.). 

Normally these loans are part of the U.S. 

Department of Education’s William D. 

Ford Federal Direct Loan Program. 

Direct Subsidized Loans, Direct 

Unsubsidized Loans, Direct PLUS 

Loans, and Direct Consolidation Loans 

are all common types of Direct Loans. 

Only certain types of Federal 

appointments are eligible. Non-career 

temporary appointments limited to 1 

year or less are not eligible. Non-career 

term appointments of less than 3 years 

are also excluded. ‘‘Schedule C’’ 

political appointments in the Title 5 

excepted service are also not eligible. 

All candidates or employees who are 

eligible, and who receive benefits, must 

sign a service agreement to remain with 

the Federal Government (sometimes 

with the specific agency) for a period no 

less than 3 years. In practice, if 

payments are made annually over the 

course of multiple years, the service 

agreement length can last as long as 6 

years under this recruitment and 

retention bonus authority. 

To ensure that Federal funds are only 

used in an appropriate and strategic 

manner, the Office of Personnel 

Management (OPM) has promulgated 

civil services implementing regulations, 

found at 5 CFR part 537. These 

regulations stipulate that this authority 

is available to job candidates, who are 

not currently part of the Federal civil 

service, when the candidates are highlyqualified and the agency otherwise 

would encounter difficulty in filling the 

positions with highly qualified 

individuals. This authority is also 

available to facilitate the retention of 

agency employees when those 

employees would otherwise be likely to 

leave the Federal service agency for 

outside employment. In the retention 

context, agencies must determine that it 

is essential to retain the employees 

based upon their high or unique 

qualifications or a special agency need. 

GSA, like many Federal agencies, has 

administrative approval controls to 

make sure that funds are only used for 

the most appropriate recruitment or 

retention cases. At GSA, the 

administrative approval process is 

currently very cumbersome and 

laborious because it requires a customwritten memorandum by a ‘‘Requesting 

Official’’ (i.e., the selecting official or 

employee’s supervisor), routed through 

a senior ‘‘Reviewing Official’’ for 

budgetary approval, and then finally 

routed through three different divisions 

within the Office of Human Resources 

and then one additional office in the 

office of the Chief Financial Officer. 

Because each memorandum is customwritten, the agency is only able to 

transactionally process a very small 

number of requests each year (i.e., 

typically 1 to 7 requests annually, across 

an agency of nearly 13,000 employees). 

In an effort to improve Government 

efficiency, GSA proposes to standardize 

and streamline its agency process for 

this personnel authority by creating a 

new agency form, GSA Form 5015, 

‘‘Student Loan Repayment Application 

and Service Agreement.’’ The purpose 

of this form will be to collect together, 

in one place, information necessary to 

determine a job candidate’s or 

employee’s eligibility. The information 

collected will include the type of loan, 

the name and address of the lender, and 

a justification statement summarizing 

the candidate’s or employee’s 

knowledge, skills and abilities that 

support a ‘‘highly-qualified’’ 

designation. The proposed form also 

will contain standard signature blocks 

for all 6 agency signatures that are 

required for transactional processing. 

The agency’s current processing 

procedures are contained within the 

public administrative Order 9537.1B, 

‘‘Student Loan Repayment Plan,’’ found 

at http://www.gsa.gov/. The proposed 

form also contains the Service 

Agreement itself, so that all signatures 

and binding terms and conditions of the 

agreement are centralized into one 

location. 

Public notice for GSA Form 5015 is 

sought because non-Federal job 

candidates may partially complete 

certain selections of the form, to aid the 

selecting official who is responsible for 

the vacancy announcement. For student 

loan repayment applications that are 

approved and processed, the GSA Form 

5015 will be placed into the future or 

existing employee’s Official Personnel 

File (OPF) as an agency temporary 

document, in accordance with the OPM 

Guide to Personnel Recordkeeping 

(available at http://www.opm.gov). 

B. Annual Reporting Burden 

Respondents: 25 per year. 

Responses Per Respondent: 1. 

Total Annual Responses: 25. 

Hours per Response: 8. 

Total Burden Hours: 200. 

C. Public Comments 

Public comments are solicited to help 

GSA understand whether or not creating 

the proposed new GSA Form 5015 will 

help to streamline the current 

consideration and approval process as 

well as save labor hours in the creation 

of requests and their subsequent 

approval and administrative routing. 

The agency would also like to know: (a) 

whether this collection of information is 

necessary, (b) whether it will have 

practical utility, (c) whether our 

estimate of the public burden of this 

collection of information is accurate 

(and based on valid assumptions and 

methodology), (d) whether or not there 

are ways to enhance the new form’s 

utility and clarity of the information to 

be collected, and (e) whether or not 

there might be ways in to minimize the 

data collection burden through the use 

of information technology. 

Obtaining Copies of Proposals: We 

have provided a copy of the proposed 

draft GSA Form 5015 at the end of this 

notice below the signature block. A 

copy of the proposed draft form can 

alternatively be obtained through GSA’s 

Regulatory Secretariat Division by 

calling (202) 501–4755 or emailing 

GSARegSec@gsa.gov. Please cite OMB 

Control No. 3090–XXXX, Student Loan 

Repayment Application and Service 

Agreement (GSA Form 5015), in all 

correspondence. 

Lois Mandell, 

Director, Regulatory Secretariat Division, 

General Services Administration. 


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GSA Form 5015 

STUDENT LOAN REPAYMENTAPPLICATION J 0MB OonttofNo;: 

ANO:SER.V"ICES:AGREEMENT' • Expiratl~ti Date;· ... .. .. 

PARTkAPPLICATION 

1. Name (Last Name,. First Name, Middle Initial) l 2. Social Security No. 

3 .. Position Title 

4. Occupational Series I 5. Pay Plan l 6. Grade 

7. GSA Component 

(j PJ;,i~lic Building Seryice (PBS) 

tl F:e,cferai Acquisition Service □ Staff Office 

If staff Office; name of Staff Office: .... 

8. Organization correl:lPQndence i:lymbol: 

9. ApPQintment Type: o Competitive Service o Excepted Service 

10. ls this a term appointment? D Yes □ No 

Note: If yes, the term appointment must be 3 years or longer or lead to PQSSible conversion to 

the competitiveffrvice. 

11. Ba$1s of application: o Recruitment □ Retention of an existing GSA ernptoyee 

If Recruitment, provide effective date•.ofGSAapPQintment (MM/OO/YYVY) 

12 .. Annual loan repayment amount (not to exceed $10,000): 

13. Number of years of requested benefits: 

□ 1 Yeat(requires 3 years of service) 

D 2 Years (requires 3 years of service) 

o 3Years (requires 3years of service) 

□ 4 Years (requires 4 years of service) 

□ 5 Years (requires 5 years of service) 

O 6· Years (requires 8 years of. service) 

N<>hl: Fon$Cl"liltment, the servicEHigreementperiod begins UPQn.appointment. For retention, 

the period begins on the date this form is sign~, 
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GSA Form 5015 

14. T;;1x Handling 

Pli\Yr(lems by the Government to third parties (sUth as lenders) ate coni;i(feted taicable 

incotre under iMome and employment tlax rul~. Y<>u have t\NO.· tiptlons on howthls tax 

Obffgatton can be handled (5 C.F.R;.§.537;106(a)(6)). Check the appropriate boX. 

D Have the taxes withheld from the payment to the lender, which Will mean that the 

actual payment tothef-,mder Will be smaller than originally anticipated; 

D Make the total paymentto the lender but have GSA Payroll setup.a collectible debt 

which can be repaid either by check written to GSA or through periodic installment 

deductions from future paychecks, under 5 U.S.C. § 5514. 

Note: There is no cost differeni:» to the job candidate or employee between eitherof these 

two ehoi~s. Neither choice involves an intere$1:eharge by GSA .. 

15. Justification Statemen~ 

~ovlde: a i:X)n,prehensiv$ jus~ficati!).llsta~rnentjwritten by supervisor anti applicant) 

Note: Stucl!ilnt loan repayrrtent b$nefflsJHe only available if the 10b candidate or GSA 

employee. can demonstrate that he otsheJs highly-qualified. FotapplieatiOns related to 

recruitment, the hiring official most demonstrate that the positi6n WQUld be difficult to fill 

Without this workplace benefit. Fol' applications based on retention, the en,ployee's current 

supervisor must demonstrate thatthe employee otherwise is likely to leave the agency for 

employment outside the Federal service and it is essential to retain the employee based on 

the. employee's high or unique qualifications or a special need of the agency. 

2 
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18. Signature of Applicant (Le. JQb Candidate or GSA Employee) 

By$ig/Jingthis.sgreement, you agree.to the. tefl'rls. attached. 

17. Date (MMlODIYYYY) 

PART II: TERMS OF AGREEMENT 

GSA Form 5015 

GSA will repay the amounts specified in the.above application directly to the holder of the 

qualifying federally-insured student loan, on the job candidate or employee's behalf. GSA is 

not obligated to pay student loan repayment benefits based upon a service agreement with 

another agency. 

The (lfOS$ repayment ali10unt$ar:e su~jl;!cttof'ecl~rai, state, and lod:11 ineornefaxandsocial 

security and Medicare taxwithhotd,ng, Whieh wm be subtracted from the.gr:()'$$ amount before 

the repayment is made to th.e hokier of theJoan(s). 

This:seMce agreement does. notconstifUfe,.a. ii9ht, promise, of entitlement for continued 

employmento'.r' non-competitiVe converslon·.to tfie.oompetitive.service. This-agreement to 

make repayments on a loan does, not exempt an employee from his or her responsibility or 

liabilityforanyloan the individual hastakenout. 

In connpfiance with 5 C.F.R. §§ 5:37J06(c)aod 107(a), GSA reserves the right to terminate a 

multi~year agreement earfy in the everit that funding is no longer available after the first year. 

A job candidate 9r employee will~. deemed to have breached this agreement if he or she 

separates from GSA voluntarily (inc;;1uding thrbughagency transfer;.appointrnent expiration, 

resignatioTI, or retirement). or involuntanly:(dulil to miscoriduct, unacceptable perfom,aTice, or a 

neg11ti\le suitability determination} befo~ fhl$agreement expires, Ajobcaodldate or employee 

will be deemed to not have breaehe.d this agreement if the involuntary separation is due to 

reasons notwithin the indiVidual'!i control, such as areduction in force. • 

1f the employee is not able to maintain an acceptable level of performance (Le, a ratlng of ''3" 

e>ut of5); fllen the employee loses eligibility forfuture payments ll!ldera multi-year 

agreement. This situation, however, does not cause a breach of agreement, and does not 

generate a collectible Govemme.nt debt 

The job candidate or employee understands that when there is a breach of this agreement 

that the individual may owe GSA a collectible Government debt, based on 31 U .S.C. 

Subchapter ll. The employee has the.right, !.lnder5U.S.C. §5379and5C.F.R, Part 537, to 

requesta waiver Of the collectible debt, ifit would be againstequify :and gobdoonscience or 

againstthe public interest. 

Internal temporary or permanent reassignments, promotions, .or-reductions in grade within 

GSA do not constitute a breach of the service agreement. Ho\Alever, if the employee moves to 

Iii new position covered by a different funcfing source (for exan,ple, from F.As to l='BS; or FIBS 

to F'AS, etc,), the new organization is not()bligabiid to contin~ multi-year b&ne~ts. In this 

case, the empJqyee must still remain in GSA.service for a 3-year minimum period or .a 

one-yein period following thiJ final payment by GSA to the lender (if longer than a 3 year 

3 
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GSA Form 6015 

service period) 

PAFtTltr: LOAN\JERIFIC.ATION INFORMATION 

1. Name of Loan Holder: 

2. Loan Holder Address: 3. Loan Holder Employer 

Identification Number (EIN) 

4, TypeofLoan 5. Do you want the payment 

tJ Federa(Family Education:Loan (pr.e2010) 

rniade by electronic funds 

transfer? •• 

o Wifliam Cl. Ford DitE!ct Loan Program 

□ Federal Perkins Loan Program Yes: 

D Lo.an under the Public Health Seivlce Act No 

Note: tryea, complete and attach 

SF-t199a 

6. Outstanding Balance of the loan($} 7. As of Date (DD/MM/YYYY) 

.. 

PART IV: APPROVAL SIGNATURES 

1. Requesting Official (Le, supervisor) 2. Date (DD/MM/YYYY) 

3. Reviewing Official (i.e .. FAS Deputy.or.Assistant 3. Date (DD/MM/YYYY) 

Commissioner, PBS Regional Commissioner, or 

HeacS of Staff Office) 

4. OHRM Director of Staffing Service Center 5. Date (DD/MM/YYYY) 

6. Deputy Chief Human Capital Officer (OHRM) 7. Date (DD/MM/YYYY) 

.8. Chief Human CapitaLOfficer (OHRM) 9. Date (DD/MM/YYYY) 

10. C.hie, Financial Officer.(OCFO) 11. Date(DO/MMIYYYY) 

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GSA Form 5015 

PRIVACY ACT STATEMENT 

Information :collected Via this forrr(is pur~antto federal law; in particular: 5 U.s.C. § 5379, 

Disclo-sute is mandatqry so that-the conect pay and ben~itts tan be provided, The 

informatioru::ollected via thisformwm <mly be used by OHRM and the employee's 

supefyisqrunder the provisions of$ U.S.Ci§552a(b)(3) (t()utine use]. such illformatioh is 

not releasable to the 9enera1 public. due to 5 u.s.c. § 552(b)(6). and will be stored within 

the Office of Personnel Manasemenrs (OPM) Electronic Personnel Folder (eOPF) 

application, under Systemof Record Notice (SORN) "OPM/GOVT•t•via the Federal 

Register at 77 FR 73694. (DecemberH, 2012). A job candidate'sfaifureto provide the 

information requested on this form may lead to the erroneous payment of benefits, or, the 

non-payment of eligible benefits. 

PAPERWORK REDUCTION ACT S.TATEMENT 

This information collection meets.the ~uirements of 44 U .s.c. § 3507, as amended by 

.section 2 ofthe Papenilitji'k Reduction.Act of 1995. You do notneed:toanswerthese 

questions unless we display a valid Office of Management an.d Budget(OMB) 

control number. The 0MB control numberfor this collectionis S000-:0329: We estimate 

that a will'take 3 hours. to read the instructions, gather the. facts, .. and:answer1he. questions .. 

Send only. comments relating to our time estimate, including suggestions for reducing this 

burden, or any other aspects ofthiscoHectlon of information to: U,S.General Services 

Administration, Regulatory Secretariat Division (MVCB}, 1800 F Street; NW, Wlshington, 

0Q20405. 

INSTRUCTIONS 

The following guidance ls provided to help the applicanfand the supervisor to be able to 

tomplete this form. 

PART I: Application 

t, Nm:ne: Provide you full, official name as containedwithinoff"icialagencyrecotds. 

Z, $Qcial Se<:urity lilumber.Noll n,ayprovida only the tast4~igUs ofyo1:1r SSN. 

3. Position Title: Provide the: offieiai title ofyour position, a!l liS~d tn your position 

description 

4.. Oce1:1pationai Seti~s: Provi~yout 4-digit oocupational$arie$. lfyou do not know 

your series, an OHRM staff i'tierilbet can provide you With thatinfoimation. 

5. Pay Plan: Provide you pay plan (Such as GS) 

6. Grade: Provide your grade, if your pay plan uses grades, otherwise, write "NIA" 

7. GSA Component Provide thl;l GSAC-Omponent that you Work for, since.this may 

impact the source of Government funds used if you are approved for this benefit. 

&. Organization Correspondence Symbol: Provide the office:corresponde11ce (i.e. mail 

~uting) symbol.. . . ... . . . • 

9 .Appointment type: ProVidewhetherornot you are in the competitive service or 

excepted service. If you do not knoW; you may ask a staff member-With OHR M. 

10. Term Appointment: PrQvide whether or not you are on a term appointment, such as a 

~1,ways Recent Graduate programappointment. ThisintQrmation Wili tielp determine 

whether or not you ate eligible fQtthis workplace benefit 

5 
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GSA Form 6015 

11. Basis of Application: Provide whether .or not this is for a job candidate new to 

Fe.deral service or if this.is an existing GSA employee. 

12. Annual Loan Repayment. Amount: Provide. here the. dollar at1nua1 amouriHhat you 

are requesting and that the Reviewing Official has approved. 

13; Number of Years. of Requested Benefits. Provide the total number of payments and 

service. agreement years covered by this application and approval. 

14, Justification Statement: Proyidea ~etailed justification stat1:1ment of tl'le skills, 

competencies, and accorrplishmentsc, which supporHhe determination that the 

employee is highly-qtJalified. To write this narrative the appl~nt and supervisor may 

drawfrom the applicant's tesllme as well as the official position de$Ctiption. These two 

documents can be attached, to facilitate application rev1ewand approval. For job 

candidates, the supervisor must also demonstrate that the position is .difficult to fill, 

such as due to employment trends, geographical labor market shortages, and pay 

disparities between the Government and .the. private sector, For current G.SA 

employees as applicants,the supervisor must demonstrate that the employee ls at risk 

ofleaving the Federal service, through resignation or retiremem. This can be based on 

the high demand of the position or occupational series, or can be due the applicant 

actually !'laving received a· 110n.-Federal·offer of employment 

ts. Signature of Applicant: T~eapplieant must sign here. The sigr!iifure mean$ that the 

applicant is willing to ba subjec:Uo ttle terms of the agreement if the appll<:111tion is 

approved. 

16. Date of Signature: Date: (ODIMMi'i¥YV) 

PART II - Nt> instructions rl'iq01red. 

PART Ill • Loan lnfOrmation 

L Name of Loan Holder: Provide the name of the lending institution or lending source 

2, Loan Holder Address:: Provide the address in case a check paymentis made 

3. Loan Holder EIN: Provfdethe IRS employer identification nuniber (used for tax 

purpose} 

4. Ty~ of loan: Provtdethe>fype of loart If your type of loan ls: not ilfledthen it is not 

eligibli:! for this benefit F'orexample, li:>11ns from pri~te banks.are not eligible. 

it Ele¢tronie Funds Tra11Sfer:. It is usualiy best to transfer funds eleetrol'iic:aily, to 

prevent paper checks from being lost. It is.recommended that applicants complete the 

SF•1199a, which is the Direct ~posit form. This provides GSAwith the appropr.iate 

electronic funds transferil"iformation. 

6. 0.utstanding Loan Balartce: Plea$e contact you lenderand generate a statement 

showing the total loan balance, as of a certain date 

7. Date of Loan Balance: Provide the date of the statement from the loan holder 

Note on Attaehrnents 

Plealse atlaehlfie: following to thili application package: 

L A OOpy of the applicant's te$ume. 

2. .A copyofthe position.de$cription foflhe position applledfor; ofofthe. incumbent 

employee applying fofthis benefit 

3. A copy of the statement from the lender :showing the loan balahce and loan 

information 

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1490 Federal Register / Vol. 90, No. 5 / Wednesday, January 8, 2025 / Notices 

[FR Doc. 2024–31659 Filed 1–7–25; 8:45 am] 

BILLING CODE 6820–FM–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30Day–25–24FU] 

Agency Forms Undergoing Paperwork 

Reduction Act Review 

In accordance with the Paperwork 

Reduction Act of 1995, the Centers for 

Disease Control and Prevention (CDC) 

has submitted the information 

collection request titled 

‘‘Comprehensive Understanding of 

Readiness for Elimination of Hepatitis C 

in Corrections (Cure-HepC)’’, to the 

Office of Management and Budget 

(OMB) for review and approval. CDC 

previously published a ‘‘Proposed Data 

Collection Submitted for Public 

Comment and Recommendations’’ 

notice on May 28, 2024, to obtain 

comments from the public and affected 

agencies. CDC received two nonsubstantive public comments related to 

the previous notice. This notice serves 

to allow an additional 30 days for public 

and affected agency comments. 

CDC will accept all comments for this 

proposed information collection project. 

The Office of Management and Budget 

is particularly interested in comments 

that: 

(a) Evaluate whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information will have 

practical utility; 

(b) Evaluate the accuracy of the 

agencies estimate of the burden of the 


lotter on DSK11XQN23PROD with NOTICES1EN08JA25.015</GPH>

GSA Form 5015 

Guidance on Completing the.SF-1199a 

t, Enter personal infotmatioriin Section 1, A. 

.2. Enter the name ofthe pel'$0n.or entifyto whom your loan payments are made in 

Section 1, 8. 

S, Enter your social ~ecurifynumbefin Section 1, Candsign. 

4. Section 1, D is not applicable, 

5, Enter the Employee Loan ACCCluntnumber in Section l, E 

6. Check "Other" and enter Student Loan Repaymentln SecHon f, F, 

7. Section 1, G is not applicable. 

8. Under Section 2, "Government Agency Name" enter GSA Fax: 816-823-5435. 

9. Under Section 2, "Government Agency Address" enter 2300 Main Street - 2NW, 

Kansas City, Missouri 64108. 

10. In. Section 3 enter name,. address, and touting numbtlr Of financial Institution; and 

11 .. Obtain name, telephone number, andsignature of institution representative. 

7