Medical Clearance Process for Deployment to the Polar Regions

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3145-0177 can be found here:

Documents and Forms

Document Name Document Type
Form NSF 1700 Medical Clearance Process for Deployment to the Polar Regions Form and Instruction
NSF 1700 Polar Medical Forms NSF 2017 PLR Med forms rev May 2017_v5.pdf Form and Instruction
Participation Letter.docx Polar Participation Letter IC Document
PQEmail-ASC_v2.docx Polar Physical Qualification letter IC Document
3145-0177 Mandatory Reading.pdf OPP Mandatory Reading for Polar Medical forms IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Clearance Process for Deployment to the Polar Regions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NSF 1700	Polar Medical Forms	NSF 2017 PLR Med forms rev May 2017_v5.pdf		Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,650	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,650	3,650
Annual IC Time Burden (Hours)	36,500	36,500
Annual IC Cost Burden (Dollars)	1,168,000	1,168,000

Documents for IC

Title	Document	Date Uploaded
Polar Participation Letter	Participation Letter.docx	06/23/2017
Polar Physical Qualification letter	PQEmail-ASC_v2.docx	06/23/2017
OPP Mandatory Reading for Polar Medical forms	3145-0177 Mandatory Reading.pdf	06/23/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.