Information Collection

Physical examination verification

IC 187130 under ICR 201703-0648-006 · OMB 0648-0318.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0648-0318 can be found here:

Documents and Forms

Document Name Document Type
0318 Info Required from Observer Provider 110315.docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Physical examination verification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 679.50

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			0318 Info Required from Observer Provider 110315.docx		Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 5

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 75 %

	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	6	6

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.