Information Collection

EHR Generic Clearance

IC 42676 under ICR 200303-3145-003 · OMB 3145-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3145-0136 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	EHR Generic Clearance	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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,423	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 9 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,423	1,700	14,723
Annual IC Time Burden (Hours)	48,041	6,600	41,441
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.