Inclusion Enrollment Form

DoD Usage of Inclusion Enrollment Report Form

OMB: 0925-0770

IC ID: 249404

Documents and Forms
Information Collection (IC) Details

View RCF Information Collection (IC)

Inclusion Enrollment Form
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 inclusion enrollment Attachment 2 Inclusion Enrollment Report.pdf Yes Yes Fillable Fileable

Health Health Care Services

Extramural Awards and Chartered Advisory Committees (IMPAC 2), Contract Information (DCIS), and Cooperative Agreement Information  67 FR 60742

2,100 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,100 0 2,100 0 0 0
Annual IC Time Burden (Hours) 2,100 0 2,100 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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