Information Collection

AENT Program Forms

IC 209293 under ICR 201701-0915-005 · OMB 0915-0375.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0375 can be found here:

Documents and Forms

Document Name Document Type
Form 1 AENT Program Forms Form and Instruction
1 ANEW Table 1 ANEW OMB Renewal - Table 1.docx Form and Instruction
2 ANEW Table 2 ANEW OMB Renewal - Table 2.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	AENT Program Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	ANEW Table 1	ANEW OMB Renewal - Table 1.docx		Yes	Yes	Fillable Fileable
Form and Instruction	2	ANEW Table 2	ANEW OMB Renewal - Table 2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 236	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	236	166	70
Annual IC Time Burden (Hours)	1,652	770	882
Annual IC Cost Burden (Dollars)	0	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.