Information Collection

DLA Form 1855-1D

IC 234115 under ICR 202202-0704-005 · OMB 0704-0582.

Documents and Forms

Document Name Document Type
Form DLA Form 1855-1D P DLA Form 1855-1D Form
DLA Form 1855-1D P DLA CYP Diabetes Daily Medical Action Plan DL1855-1D Part I - OMB Review Final.pdf Form
DLA Form 1855-1D P DLA CYP Diabetes Daily Medical Action Plan DL1855-1D Part I - OMB Review Final.pdf Form
DLA Form 1855-1D P DLA CYP Diabetes Emergency Medical Action Plan DL1855-1D Part II - OMB Review Final.pdf Form
DLA Form 1855-1D P DLA CYP Diabetes Emergency Medical Action Plan DL1855-1D Part II - OMB Review Final.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	DLA Form 1855-1D	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	DLA Form 1855-1D Part 1	DLA CYP Diabetes Daily Medical Action Plan	DL1855-1D Part I - OMB Review Final.pdf		Yes	Yes	Fillable Fileable Signable
Form	DLA Form 1855-1D Part 2	DLA CYP Diabetes Emergency Medical Action Plan	DL1855-1D Part II - OMB Review Final.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-6	6
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	-11	11

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.