NAT Forms

Nurse Anesthetist Traineeship (NAT) Program

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.