Information Collection

Prescription, Authorization, Application, Procurement, Repair, And Loan Of Prosthetic Items

IC 147503 under ICR 199112-2900-004 · OMB 2900-0188.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0188 can be found here:

Documents and Forms

Document Name Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PRESCRIPTION, AUTHORIZATION, APPLICATION, PROCUREMENT, REPAIR, AND LOAN OF PROSTHETIC ITEMS	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.	Available Electronically?	Can Be Submitted Electronically?
Form	FL- 10-90	No	No
Form	FL 10-426	No	No
Form	10-1394	No	No
Form	10-2421	No	No
Form	10-2520	No	No
Form	10-2914	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 512,844	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	512,844	512,844
Annual IC Time Burden (Hours)	51,284	51,284
Annual IC Cost Burden (Dollars)	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.