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Medical Reports
Medical Reports
OMB: 3220-0038
IC ID: 33852
OMB.report
RRB
OMB 3220-0038
ICR 199908-3220-001
IC 33852
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0038 can be found here:
2023-12-29 - Extension without change of a currently approved collection
2019-12-23 - Revision 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:
Medical Reports
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
G-3EMP
No
No
Form
G-250
No
No
Form
G-250A
No
No
Form
G-260
No
No
Form
RL-11D
No
No
Form
RL-11B
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
29,950
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 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
29,950
0
0
-31,000
0
60,950
Annual IC Time Burden (Hours)
12,417
0
0
-12,770
0
25,187
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.