Information Collection

25 CFR 36.97(c) - Parents/guardians waive non-emergency services

IC 181382 under ICR 202211-1076-001 · OMB 1076-0164.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0164 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
25 CFR 36.97(c) - Parents/guardians waive non-emergency services	Form and Instruction
Authorization of Medical Care of a Minor 25 CFR Part 36.97C BIE Autorization of Medical Care of a Minor GUIDANCE DOCUMENT.docx	Form and Instruction
Authorization of Medical Care of a Minor 25 CFR Part 36.97C BIE Autorization of Medical Care of a Minor GUIDANCE DOCUMENT.docx	Form and Instruction

IC Title:

25 CFR 36.97(c) - Parents/guardians waive non-emergency services

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 36.97(c)

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	N/A	Authorization of Medical Care of a Minor	25 CFR Part 36.97C BIE Autorization of Medical Care of a Minor GUIDANCE DOCUMENT.docx		Yes	Yes	Printable Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 440

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	440	430	10
Annual IC Time Burden (Hours)	110	107	3
Annual IC Cost Burden (Dollars)	0	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.