Information Collection

6-Month Post-TED

IC 237625 under ICR 202004-0915-001 · OMB 0915-0310.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0310 can be found here:

Documents and Forms

Document Name Document Type
Form 5 6-Month Post-TED Form
5 6 MONTH POST-TED 4-7-20 04.03.2020 Updated Clean OMB 0915-0310 F2450 R5 (03Apr2020).docx Form
5 R 6 MONTH POST-TED REDLINE 4-7-20 04.03.2020 Updated Form 0310 F2450 REDLINE.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	6-Month Post-TED	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5	6 MONTH POST-TED 4-7-20	04.03.2020 Updated Clean OMB 0915-0310 F2450 R5 (03Apr2020).docx		Yes	Yes	Fillable Fileable
Form	5 R	6 MONTH POST-TED REDLINE 4-7-20	04.03.2020 Updated Form 0310 F2450 REDLINE.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	8,600	8,600
Annual IC Time Burden (Hours)	7,310	7,310
Annual IC Cost Burden (Dollars)	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.