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Federal forms, ICRs, and supporting documents

Information Collection

Chronic obstructive pulmonary disease National Action Plan Tracking System - Preliminary Model (Private Sector)

IC 241709 under ICR 202301-0925-002 · OMB 0925-0766.

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

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Chronic obstructive pulmonary disease National Action Plan Tracking System - Preliminary Model (Private Sector)
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Blueprint Handout Blueprint handout rev6 20200206 (005)_NA (1).docx Yes Yes Fillable Fileable

Health Health Care Services

 

20 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 80 0 0 0 0 80
Annual IC Time Burden (Hours) 80 0 0 0 0 80
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Mini SSA COPD Clearance_NHLBI_Final (1).docx 05/06/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.