Information Collection

NAT Forms

IC 209481 under ICR 201311-0915-005 · OMB 0915-0374.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0374 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NAT Forms	Form and Instruction
1 Table 1 Table 1 NAT forms.docx	Form and Instruction
2A Table 2A Table 2A NAT Forms.docx	Form and Instruction
2B Table 2B Table 2B NAT forms.docx	Form and Instruction

IC Title:

NAT Forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Table 1	Table 1 NAT forms.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2A	Table 2A	Table 2A NAT Forms.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2B	Table 2B	Table 2B NAT forms.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	774	774
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.