Information Collection

Special Agent Medical (Preplacement/Incumbent)

IC 12813 under ICR 202004-1140-005 · OMB 1140-0056.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1140-0056 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ATF F 2300.10 Special Agent Medical (Preplacement/Incumbent)	Form and Instruction
ATF F 2300.10 Special Agent Medical (Preplacement/Incumbent) F 2300. 10 (December 2019) with watermark.pdf	Form and Instruction

IC Title:

Special Agent Medical (Preplacement/Incumbent)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 339.301

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ATF F 2300.10	Special Agent Medical (Preplacement/Incumbent)	F 2300. 10 (December 2019) with watermark.pdf		No		Printable Only

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 288

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	288	168	120
Annual IC Time Burden (Hours)	216	126	90
Annual IC Cost Burden (Dollars)	3,600	2,160	1,440

Documents for IC

table that charts IC Documents
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.