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Information Collection

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

IC 147972 under ICR 198610-2900-005 · OMB 2900-0338.

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Information Collection (IC) Details

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REQUEST TO FIRM FOR ESTIMATE OF COST FOR PURCHASE OR REPAIR OF PROSTHETIC APPLIANCES
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FL 10-90 No No


    

22,500 0
   
Private Sector Businesses or other for-profits
 
   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 22,500 0 0 22,500 0 0
Annual IC Time Burden (Hours) 1,800 0 0 1,800 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.