Information Collection

Prescription for Eyeglassess

IC 201724 under ICR 201808-0420-004 · OMB 0420-0550.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PC-OMS-116 Prescription for Eyeglassess	Form and Instruction
PC-OMS-116 Prescription for Eyeglassess Eyeglass_Prescription_Measurement.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

PC-OMS-116

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PC-OMS-116	Prescription for Eyeglassess	Eyeglass_Prescription_Measurement.docx		Yes	No	Fillable Printable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title: Prescription for Eyeglassess

FR Citation: 70 FR 1

Number of Respondents: 3,293

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	3,293	3,293
Annual IC Time Burden (Hours)	3,293	3,293
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.