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Federal forms, ICRs, and supporting documents

Information Collection

Panel Replenishment Baseline and Enrollment Survey

IC 216701 under ICR 202004-0910-008 · OMB 0910-0815.

Documents and Forms
Document Name
Document Type
Other-Respondent Materials - English
Other-Respondent Materials - Spanish
Information Collection (IC) Details

View Information Collection (IC)

Panel Replenishment Baseline and Enrollment Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Respondent Materials - English Attachment_3_Respondent_Materials_English_CLEAN_042220.pdf No   Printable Only
Other-Respondent Materials - Spanish Attachment_4_Respondent_Materials_Spanish_CLEAN_042220.pdf No   Printable Only

Health Consumer Health and Safety

 

5,000 0
   
Individuals or Households
 
   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 1,650 0 0 0 0 1,650
Annual IC Time Burden (Hours) 826 0 0 0 0 826
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.