Domestic Assurance (Renewal)

Assurance (Interinstitutional, Foreign, and Domestic) and Annual Report (Office of Director)

OMB: 0925-0765

IC ID: 237704

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

View Information Collection (IC)

Domestic Assurance (Renewal)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 Domestic Assurance Domestic Assurance.doc Yes Yes Fillable Fileable

Health Health Care Services

 

220 0
   
Individuals or Households
 
   100 %

  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 220 0 220 0 0 0
Annual IC Time Burden (Hours) 5,720 0 5,720 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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