# 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 *[email protected]* 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: Health Education Assistance Loan (HEAL) Program: Lender's Application for Insurance Claim Form and Request for Collection Assistance Form (OMB No. 0915-0036)—Extension**
The clearance request is for an extension of two forms that are currently approved by OMB. HEAL lenders use the Lenders Application for Insurance Claim to request payment from the Federal Government for federally insured loans lost due to borrowers' death, disability, bankruptcy, or default. The Request for Collection Assistance form is used by HEAL lenders to request federal assistance with the collection of delinquent payments from HEAL borrowers. The annual estimate of burden is as follows:
| Form | Number of | Responses per respondent | Total responses | Hours per | Total burden hours |
| --- | --- | --- | --- | --- | --- |
| Lender's Application for Insurance Claim Form 510 | 13 | 28 | 364 | 0.50 | 182 |
| Request for Collection Assistance Form 513 | 13 | 445 | 5,785 | 0.17 | 983 |
| Total Burden | 26 | | | | 1,165 |
Written comments and recommendations concerning the proposed information collection should be sent within 30 days of this notice to the desk officer for HRSA, either by e-mail to *[email protected]* or by fax to 202-395-6974. Please direct all correspondence to the “attention of the desk officer for HRSA.”
Dated: August 11, 2011.
Reva Harris,
Acting Director, Division of Policy and Information Coordination.