Information Collection

2-Year Post-TED

IC 237627 under ICR 202109-0915-001 · OMB 0915-0310.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0310 can be found here:

Documents and Forms

Document Name Document Type
Form 7 2-Year Post-TED Form
FORM 4-8 - 2450 R6.docx Other-changes/adds in blue highlight
FORM 4-8 - 2450 R6.docx Other-changes/adds in blue highlight
7 2 Year Post-TED 2450 R5 (current, approved for).pdf FORM 4 thru 8 2450 R5 (current, approved for).pdf Form
7 2 Year Post-TED 2450 R5 (current, approved for).pdf FORM 4 thru 8 2450 R5 (current, approved for).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	2-Year Post-TED	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	7	2 Year Post-TED 2450 R5 (current, approved for).pdf	FORM 4 thru 8 2450 R5 (current, approved for).pdf		Yes	Yes	Fillable Fileable
Other-changes/adds in blue highlight			FORM 4-8 - 2450 R6.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,800	6,800
Annual IC Time Burden (Hours)	4,420	4,420
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.