Download:
pdf |
pdf Non-visible Questions
Label
Why
not?
PDF Name
(step)
Other Eligible
Entity
Attestation (1)
Location
Response
Input Item
Below the Yes Text Entry
and No radio
buttons
Visibility Trigger
Other
The field is displayed
if the user selects the
No radio button
State Changes
Label
PDF Name
Item Type
Trigger
OMB Number: 09150126 Expiration Date:
mm/dd/yyyy
Other Eligible
Entity
Attestation
Modal
When the user selects the link the modal
is displayed with the public burden
statement content.
| File Type | application/pdf |
| File Title | Other Eligible Entity Attestation |
| Subject | NPDB attestation |
| Author | Health Resources and Services Administration |
| File Modified | 2020-11-19 |
| File Created | 2020-07-29 |