OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Event Record

IC 254444 under ICR 202206-0915-001 · OMB 0915-0281.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Event Record
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction B_Event Record Form_2021.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

12,980 0
   
Individuals or Households
 
   0 %

  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 12,980 0 12,980 0 0 0
Annual IC Time Burden (Hours) 2,596 0 2,596 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Event Record Event Record_Final 5.4.2022.docx 06/30/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.