Become a Partner Screen Shots

Become a Partner

OMB: 0920-1017

IC ID: 211179

Information Collection (IC) Details

View Information Collection (IC)

Become a Partner Screen Shots
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screenshots Attachment F_Screen Shot_Become a Partner Online Form.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

100 0
   
Individuals or Households
 
   100 %

  Approved 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 100 0 100 0 0 0
Annual IC Time Burden (Hours) 25 0 25 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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