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Federal forms, ICRs, and supporting documents

Information Collection

Hemophilia Treatment Center Factor Replacement Data Sheet

IC 181184 under ICR 200707-0915-002 · OMB 0915-0312.

Documents and Forms
Document Name
Document Type
Form
Form
IC Document
Information Collection (IC) Details

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Hemophilia Treatment Center Factor Replacement Data Sheet
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Data Sheet Data Sheet FINALFRPdatasheet-06-22-2007.doc Yes Yes Fillable Fileable

Health Health Care Services

 

68 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  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 68 0 68 0 0 0
Annual IC Time Burden (Hours) 2,040 0 2,040 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions FINALFRPDataSheetInstructions-06-22-2007.doc 07/06/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.