OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

AFU Year 5

IC 211987 under ICR 201406-0925-002 · OMB 0925-0584.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

AFU Year 5
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 AFU-Year 5 Annual Followup English AFU-Y5 Annual Followup_Y5_1-14-2014_English.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

14,259 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 14,259 0 14,259 0 0 0
Annual IC Time Burden (Hours) 3,565 0 3,565 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
AFU Year 5 Annual Followup Spanish AFU Y5 Annual Followup-Y5-1-14-2014-Spanish.pdf 06/23/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.