Professional Qualifications Medical/Peer Reviewers

Professional Qualifications, Medical and Peer Reviewers

OMB: 0720-0005

IC ID: 5569

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Professional Qualifications Medical/Peer Reviewers
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form DHA 780 DHA 780 dha780_20160323.pdf Yes Yes Fillable Fileable Signable
Instruction Instructions for DHA 780.pdf Yes No Fillable Fileable
Other-Privacy Act Review - No PAS required Privacy Act Review - No PAS Needed.doc No   Paper Only

Defense and National Security Operational Defense

 

60 0
   
Private Sector Businesses or other for-profits
 
   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 60 0 0 0 60 0
Annual IC Time Burden (Hours) 20 0 5 0 15 0
Annual IC Cost Burden (Dollars) 1,800 0 1,050 0 750 0

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

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