Smallpox Vaccine Injury Compensation Program

ICR 200404-0915-001

OMB: 0915-0282

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
6536
Migrated
ICR Details
0915-0282 200404-0915-001
Historical Active 200312-0915-001
HHS/HSA
Smallpox Vaccine Injury Compensation Program
Extension without change of a currently approved collection   No
Regular
Approved with change 08/02/2004
Retrieve Notice of Action (NOA) 04/22/2004
Approved consistent with HRSA memo submitted to OMB 07/22/04.
  Inventory as of this Action Requested Previously Approved
08/31/2007 08/31/2007 08/31/2004
2,500 0 2,500
7,500 0 7,500
0 0 0

The information collection requirements for the Smallpox Injury Compensation Program are needed by the Secretary to make a determination as to the provision of benefits to eligible individuals.

None
None


No

1
IC Title Form No. Form Name
Smallpox Vaccine Injury Compensation Program

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,500 2,500 0 0 0 0
Annual Time Burden (Hours) 7,500 7,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/22/2004


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