Information Collection Request

Day of Service Application Instructions

ICR 201610-3045-001 · OMB 3045-0180 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Day of Service Application Instructions Form and Instruction New Available
Day of Service Justification.doc Supporting Statement A Uploaded 2016-10-11 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
223904 Day of Service Application Instructions Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2019 36 Months From Approved
70 0 0
1,400 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Day of Service Application Instructions 1 Day of Service Application Instructions

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 70 0 0 70 0 0
Annual Time Burden (Hours) 1,400 0 0 1,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No