Information Collection
Observer/catch provider permits and appeals
IC 208762 under ICR 201309-0648-010 · OMB 0648-0619.
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0648-0619 can be found here:
Documents and Forms
| Document Name | Document Type |
|---|---|
| Form | |
| Instruction | |
Provider_Permit_App(082913)final.docx | Form |
Provider_Permit_Renewal_Form(082913)final.docx | Form and Instruction |