Reactive Tuberculin Test Evaluation Form

Individual Specific Medical Evaluation Forms (15)

OMB: 0420-0550

IC ID: 201718

Information Collection (IC) Details

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Reactive Tuberculin Test Evaluation Form PC-262-12
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction PC-262-12 Reactive Tuberculin Test Evaluation Form Reactive_Tuberculin_Test_ Eval.docx Yes No Fillable Printable

International Affairs and Commerce International Development and Humanitarian Aid

Reactive Tuberculin Test Evaluation Form  70 FR 1

392 0
   
Individuals or Households
 
   0 %

  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 392 0 -312 0 0 704
Annual IC Time Burden (Hours) 686 0 -1,426 0 0 2,112
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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