Information Collection

Notifications of Intent to Use a Voucher

IC 219016 under ICR 201511-0910-002 · OMB 0910-0822.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0822 can be found here:

Documents and Forms

Document Name Document Type
FINAL GUIDANCE TROPICAL DISEASE VOUCHER.pdf.doc Other-Guidance

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notifications of Intent to Use a Voucher	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Guidance			FINAL GUIDANCE TROPICAL DISEASE VOUCHER.pdf.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	40	40
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.