Information Collection

Request To Firm For Estimate Of Cost For Purchase Or Repair Of Prosthetic Appliances

IC 174661 under ICR 198409-2900-038 · OMB 2900-0338.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0338 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	REQUEST TO FIRM FOR ESTIMATE OF COST FOR PURCHASE OR REPAIR OF PROSTHETIC APPLIANCES	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	FL 10-90				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	22,500	2,500	20,000
Annual IC Time Burden (Hours)	1,860	260	1,600
Annual IC Cost Burden (Dollars)	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.