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Insulin Dependent Diabetic Supplement Documentation Form

IC 201719 under ICR 201808-0420-004 · OMB 0420-0550.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Insulin Dependent Diabetic Supplement Documentation Form
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction PC-262-10 Insulin Dependent Diabetic Supplemental Documentation Form Insulin_Dependent_Diabetic_Supp_Doc.docx Yes No Fillable Printable

International Affairs and Commerce International Development and Humanitarian Aid

Insulin Dependent Diabetic Supplemental Documentation Form   70 FR 1

14 0
   
Individuals or Households
 
   0 %

  Requested 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 14 0 0 0 0 14
Annual IC Time Burden (Hours) 16 0 0 0 0 16
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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