Information Collection

Global Reimbursement Checklist

IC 243131 under ICR 202103-0750-001 · OMB 0750-0003.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TAB A3 - Global Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx	Instruction
TAB A3 - Global Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx	Instruction

IC Title:

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			TAB A3 - Global Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

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, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	200	0	200
Annual IC Time Burden (Hours)	960,000	0	960,000
Annual IC Cost Burden (Dollars)	54,489,600	-1,000,000	55,489,600

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.