Information Collection

DIR Grant Reviewer Recruitment Form

IC 6550 under ICR 201612-0915-001 · OMB 0915-0295.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0295 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 DIR Grant Reviewer Recruitment Form	Form and Instruction
1 RRM Screen Shots RRM Screen Shots 2.pdf	Form and Instruction
Reviewer notice letter.docx Reviewer notice letter	IC Document

IC Title:

DIR Grant Reviewer Recruitment Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	RRM Screen Shots	RRM Screen Shots 2.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5,250	5,250
Annual IC Time Burden (Hours)	1,707	1,707
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Reviewer notice letter	Reviewer notice letter.docx	11/06/2013

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