Information Collection

4 YR Resident Physician

IC 185760 under ICR 200807-0990-001 · OMB 0990-0332.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0990 4 YR Resident Physician	Form
0990 Y4R - SBMA 0990-Evaluation of AfghanistanAppendix I_Y4R 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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	0990	Y4R - SBMA	0990-Evaluation of AfghanistanAppendix I_Y4R 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: 8

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.