OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

USMC Child and Youth Programs Forms

IC 228240 under ICR 202206-0703-004 · OMB 0703-0068.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form NAVMC 1750/5
USMC Child and Youth Programs Forms		 Form and Instruction
Form NAVMC 1750/5
USMC Child and Youth Programs Registration Form USMC Child and Youth Programs Forms		 Form and Instruction
Form NAVMC 11720
USMC Family Care Programs Consent to Release Information USMC Child and Youth Programs Forms		 Form
Form NAVMC 1750/4
USMC Child and Youth Programs Health Assessment USMC Child and Youth Programs Forms		 Form
Form NAVMC 1750/7
USMC Child and Youth Programs Non-Medicated Topical Products Authorization USMC Child and Youth Programs Forms		 Form and Instruction
Form NAVMC 1750/10
USMC Child and Youth Programs Medication Authorization and Administration Record USMC Child and Youth Programs Forms		 Form and Instruction
Form NAVMC 1750/11
USMC Child and Youth Programs Controlled Medication Authorization, Administration Record and Daily Log USMC Child and Youth Programs Forms		 Form and Instruction
NAVMC 1750/5 USMC Child and Youth Programs Registration Form
NAVMC 1750_5.pdf 		Form and Instruction
NAVMC 1750/5 USMC Child and Youth Programs Registration Form
NAVMC 1750_5.pdf 		Form and Instruction
NAVMC 11720 USMC Family Care Programs Consent to Release Information
NAVMC 11720.pdf 		Form
NAVMC 11720 USMC Family Care Programs Consent to Release Information
NAVMC 11720.pdf 		Form
NAVMC 1750/4 USMC Child and Youth Programs Health Assessment
NAVMC 1750_4.pdf 		Form
NAVMC 1750/4 USMC Child and Youth Programs Health Assessment
NAVMC 1750_4.pdf 		Form
NAVMC 1750/7 USMC Child and Youth Programs Non-Medicated Topical Prod
NAVMC 1750_7.pdf 		Form and Instruction
NAVMC 1750/7 USMC Child and Youth Programs Non-Medicated Topical Prod
NAVMC 1750_7.pdf 		Form and Instruction
NAVMC 1750/10 USMC Child and Youth Programs Medication Authorization a
NAVMC 1750_10.pdf 		Form and Instruction
NAVMC 1750/10 USMC Child and Youth Programs Medication Authorization a
NAVMC 1750_10.pdf 		Form and Instruction
NAVMC 1750/11 USMC Child and Youth Programs Controlled Medication Auth
NAVMC 1750_11.pdf 		Form and Instruction
NAVMC 1750/11 USMC Child and Youth Programs Controlled Medication Auth
NAVMC 1750_11.pdf 		Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

layout table

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
Form and Instruction NAVMC 1750/5 Yes Yes Fillable Fileable Signable
Form NAVMC 11720 Yes Yes Fillable Fileable Signable
Form NAVMC 1750/4 Yes Yes Fillable Fileable Signable
Form and Instruction NAVMC 1750/7 Yes Yes Fillable Fileable Signable
Form and Instruction NAVMC 1750/10 Yes Yes Fillable Fileable Signable
Form and Instruction NAVMC 1750/11 Yes Yes Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 247,500 0 135,500 0 0 112,000
Annual IC Time Burden (Hours) 115,917 0 -15,123 0 0 131,040
Annual IC Cost Burden (Dollars) 4,028,104 0 1,707,464 0 0 2,320,640

Documents for IC
table that charts IC Documents
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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