Information Collection

GHSP Professional Reference Form

IC 226755 under ICR 201705-0420-003 · OMB 0420-0562.

Documents and Forms

Document Name Document Type
Form PC-2172 GHSP Professional Reference Form Form and Instruction
PC-2172 GHSP Professional Reference Form Professional Reference form GHSP.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	GHSP Professional Reference Form	Agency IC Tracking Number:	PC-2172

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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	PC-2172	GHSP Professional Reference Form	Professional Reference form GHSP.docx		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	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.