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Request For Advance Or Reimbursement
REQUEST FOR ADVANCE OR REIMBURSEMENT
OMB: 0990-0059
IC ID: 116547
OMB.report
HHS/HHSDM
OMB 0990-0059
ICR 198111-0990-002
IC 116547
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0059 can be found here:
1991-03-12 - No material or nonsubstantive change to a currently approved collection
1990-09-12 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
REQUEST FOR ADVANCE OR REIMBURSEMENT
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
OS-21-81
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
6,997
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
83,964
0
0
0
0
83,964
Annual IC Time Burden (Hours)
20,991
0
0
0
0
20,991
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.