Information Collection

Web Re-Entry iCLIC

IC 186347 under ICR 200904-0925-001 · OMB 0925-0594.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0594 can be found here:

Documents and Forms

Document Name Document Type
Form 8 Web Re-Entry iCLIC Form
8 Web Re-Entry Att 8_Re-Entry Screenshots.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Web Re-Entry iCLIC	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	8	Web Re-Entry	Att 8_Re-Entry Screenshots.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,716	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10,296	8,536	1,760
Annual IC Time Burden (Hours)	858	711	147
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.