OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient

IC 186197 under ICR 200904-1090-001 · OMB 1090-0007.

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

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CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient CFI 175, CFI 176, CFI 177, CFI 178
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CFI 175 ED NCES questionnaire CFI 175 ED NCES.doc Yes Yes Fillable Fileable
Form CFI 176 DOT FAA ATO questionnaire CFI 176 DOT FAA ATO.doc Yes Yes Fillable Fileable
Form CFI 177 DOD Tricare Outpatient questionnaire CFI 177 DOD Tricare Outpatient.doc No   Paper Only
Form CFI 178 DOD Tricare Inpatient CFI 178 DOD Tricare Inpatient.doc No   Paper Only

General Government Central Records & Statistical Mgt

 

1,040 0
   
Individuals or Households
 
   50 %

  Requested 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 1,040 0 0 0 0 0
Annual IC Time Burden (Hours) 208 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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