Information Collection

Agent Registration (Initial)

IC 214933 under ICR 202310-0915-003 · OMB 0915-0126.

Documents and Forms

Document Name Document Type
Form 31 Agent Registration (Initial) Form and Instruction
31 Agent Registration (Initial).pdf Agent Registration (Initial).pdf Form and Instruction
31 Agent Registration (Initial).pdf Agent Registration (Initial).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Agent Registration (Initial)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	31	Agent Registration (Initial).pdf	Agent Registration (Initial).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: System of Record Notice 09-15-0054	FR Citation: 88 FR 17854

Number of Respondents: 78	Number of Respondents for Small Entity: 10

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	78	34	44
Annual IC Time Burden (Hours)	78	34	44
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.