Information Collection

Medical Transfer Application

IC 180929 under ICR 200805-0648-005 · OMB 0648-0569.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Medical Transfer Application	Form and Instruction
Application for medical transfer of IFQ MTPH form 062907.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Application for medical transfer of IFQ	MTPH form 062907.pdf		Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: NOAA-17, Permits and Registrations for Fisheries of the EEZ off the Coast of Alaska

FR Citation: 70 FR 10362

Number of Respondents: 211

Number of Respondents for Small Entity: 211

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	211	211
Annual IC Time Burden (Hours)	422	422
Annual IC Cost Burden (Dollars)	1,163	1,163

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.