Form 10-2201E, "Physician Consent Form"

United States Park Police Pre-Employment Suitability Determination Process

OMB: 1024-0245

IC ID: 222239

Information Collection (IC) Details

View Information Collection (IC)

Form 10-2201E, "Physician Consent Form"
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form 10-2201E Physician Consent Form 1024-0245 Form 10-2201E Physician Consent Form.pdf Yes No Fillable Printable

Workforce Management Training and Employment

OPM/GOVT-5 -Recruiting, Examining, and Placement Records  79 FR 16834

1,700 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved 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 1,700 0 0 -800 0 2,500
Annual IC Time Burden (Hours) 283 0 0 -342 0 625
Annual IC Cost Burden (Dollars) 17 0 0 -233 0 250

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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