Information Collection

SCI: Collections of Medical Records

IC 252899 under ICR 202204-2127-002 · OMB 2127-0706.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ROCIS - Non CFR_Instrument Explanation.docx	Other-Non CFR and Instrument Explana
ROCIS - Non CFR_Instrument Explanation.docx	Other-Non CFR and Instrument Explana

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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
Other-Non CFR and Instrument Explanation					No		Printable Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 16 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

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.

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