Information Collection

Technical(4) Legal (2) Management (2)

IC 210728 under ICR 201403-0990-003 · OMB 0990-0419.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0419 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Technical(4) Legal (2) Management (2)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 48 CFR 327 and 352

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 63	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	63	63
Annual IC Time Burden (Hours)	504	504
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.