Information Collection

Observer Provider Requirement - Physical Examination Verification

IC 187130 under ICR 202401-0648-005 · OMB 0648-0318.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0648-0318 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0318 Info Required from Observer Provider.docx	Instruction
0318 Info Required from Observer Provider.docx	Instruction

IC Title:

Observer Provider Requirement - Physical Examination Verification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 50 CFR 679.52(b)(11)(iii)

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
Instruction			0318 Info Required from Observer Provider.docx		Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

Number of Respondents for Small Entity: 3

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	384	384
Annual IC Time Burden (Hours)	32	32
Annual IC Cost Burden (Dollars)	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.