OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Physicians

IC 196028 under ICR 201102-0925-010 · OMB 0925-0632.

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

View Information Collection (IC)

Physicians
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Screener N44DA-9-2214Attachment3ScreeningTool_March2011.doc Yes Yes Fillable Fileable
Form and Instruction 2 Assessment N44DA-9-2214-Attachment5AssessmentForms_March2011.doc Yes Yes Fillable Fileable

Education Higher Education

 

80 0
   
Individuals or Households
 
   0 %

  Approved 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 240 0 240 0 0 0
Annual IC Time Burden (Hours) 180 0 180 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
N44DA-9-2214-Attachment4InitialContact_March2011 N44DA-9-2214-Attachment4InitialContact_March2011.doc 04/04/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.