NOTIFICATION OF SUSPENSION OR REVOCATION OF LICENSE OF A PRACTITIONER

ICR 198307-1117-005

OMB: 1117-0002

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1117-0002 198307-1117-005
Historical Active 198201-1117-005
DOJ/DEA
NOTIFICATION OF SUSPENSION OR REVOCATION OF LICENSE OF A PRACTITIONER
Revision of a currently approved collection   No
Regular
Approved without change 09/20/1983
Retrieve Notice of Action (NOA) 07/22/1983
  Inventory as of this Action Requested Previously Approved
09/30/1986 09/30/1986 08/31/1983
300 0 300
680 0 680
0 0 0

THE DEA FORM 276 IS A UNIFORM REPORTING VEHICLE USED BY STATE GOVERNMENTS TO REPORT TO DEA ACTIONS THAT LIMIT OR REVOKE THE STATE LICENSES UPON WHICH DEA REGISTRATION IS BASED. DEA IN TURN CAN THEN TAKE SUITABLE ACTION RELATING TO THE DEA REGISTRATION.

None
None


No

1
IC Title Form No. Form Name
NOTIFICATION OF SUSPENSION OR REVOCATION OF LICENSE OF A PRACTITIONER DEA 276, DEA-276A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 300 300 0 0 0 0
Annual Time Burden (Hours) 680 680 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/22/1983


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