Special Agent Medical Preplacement

ICR 200405-1140-004

OMB: 1140-0056

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
12813 Migrated
ICR Details
1140-0056 200405-1140-004
Historical Active 200301-1140-070
DOJ/ATF
Special Agent Medical Preplacement
Extension without change of a currently approved collection   No
Regular
Approved without change 07/07/2004
Retrieve Notice of Action (NOA) 05/28/2004
  Inventory as of this Action Requested Previously Approved
07/31/2007 07/31/2007 07/31/2004
300 0 300
225 0 225
1,000 0 0

The information collected is used to determine medical suitabilit to qualify for a position that has specific medical standards and physical requirements. The information will also be used to make a recommendation on either hiring or not hiring an applicant

None
None


No

1
IC Title Form No. Form Name
Special Agent Medical Preplacement ATF-F-2300.10

  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 300 300 0 0 0 0
Annual Time Burden (Hours) 225 225 0 0 0 0
Annual Cost Burden (Dollars) 1,000 0 0 1,000 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.
05/28/2004


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