3rd Year Resident Physician

Evaluation of the Afghanistan Health Initiative Project

Documents and Forms

Document Name Document Type
Form 0990 3rd Year Resident Physician Form
0990 Y3R- SBMA 0990-Evaluation of AfghanistanAppendix H_Y3R SBM_with cover June25.doc Form
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc 0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25 IC Document

Information Collection (IC) Details

IC Title:	3rd Year Resident Physician	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0990	Y3R- SBMA	0990-Evaluation of AfghanistanAppendix H_Y3R SBM_with cover June25.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9	9
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25	0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	07/10/2008

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