JSC Form 1830 – Report of Medical Examination

JSC Form 1830 – Report of Medical Examination

OMB: 2700-0170

IC ID: 234962

Information Collection (IC) Details

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JSC Form 1830 – Report of Medical Examination
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1830 Report of Medical Examination 2700-0170 2023 JF1830.docx Yes Yes Fillable Fileable

General Science and Innovation Scientific and Technological Research and Innovation

NASA 10HIMS - Health Information Management System   86 FR 71097

30 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  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 30 0 0 0 30 0
Annual IC Time Burden (Hours) 45 0 0 0 45 0
Annual IC Cost Burden (Dollars) 2,250 0 0 0 2,250 0

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