Information Collection

NAT Forms

IC 209481 under ICR 201910-0915-003 · OMB 0915-0374.

Documents and Forms

Document Name Document Type
Form 1 NAT Forms Form and Instruction
FINALNAT 2019 - Table 1 - Track Changes.docx Other-Table 1 Tracked Changes
FINALNAT 2019 - Table 2 - Track Changes.docx Other-Table 2 Tracked Changes
1 Table 1 FINALNAT 2019 - Table 1.docx Form and Instruction
2 Table 2 FINALNAT 2019 - Table 2.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NAT Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Table 1	FINALNAT 2019 - Table 1.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2	Table 2	FINALNAT 2019 - Table 2.docx	Yes	Yes	Fillable Fileable
Other-Table 1 Tracked Changes			FINALNAT 2019 - Table 1 - Track Changes.docx	No		Printable Only
Other-Table 2 Tracked Changes			FINALNAT 2019 - Table 2 - Track Changes.docx	No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	0	100
Annual IC Time Burden (Hours)	630	10	620
Annual IC Cost Burden (Dollars)	0	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.