Information Collection

42 CFR 70.3 Applicant Traveler

IC 6924 under ICR 201301-0920-007 · OMB 0920-0488.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
42 CFR 70.3 Applicant Traveler Form
Att 3 - Restriction on Travel of Persons
Attachment 3 Ill Person Travel Permit_Added.doc
Form
09-20-0171.pdf
SORN 09-20-0171
IC Document

Information Collection (IC) Details

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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 none Att 3 - Restriction on Travel of Persons Attachment 3 Ill Person Travel Permit_Added.doc Yes No Fillable Printable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 2,000 0 0 0 0 2,000
Annual IC Time Burden (Hours) 500 0 0 0 0 500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
SORN 09-20-0171 09-20-0171.pdf 06/25/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.