Information Collection

2022 ICARE OLAW Conversations Registration (OD)

IC 250855 under ICR 202010-0925-003 · OMB 0925-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Registration form screenshot 2022 ICARE OLAW Conversations Registration (OD)	Form and Instruction
1 Registration form screenshot OLAW Conversations registration screenshots.docx	Form and Instruction
ICARE OLAW Conversations 2022 Registration Generic template.docx sub-study for ICARE 2022 Conversations registration	IC Document
[EXTERNAL] ICARE VIRTUAL SESSIONS 2022 Registration Confirmation.pdf invitation	IC Document

IC Title:

2022 ICARE OLAW Conversations Registration (OD)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub-study for ICARE 2022 Conversations registration		12/20/2021
invitation		12/20/2021

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

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