Information Collection

Final Video Submission Posting Form (Attachment B50)

IC 265723 under ICR 202408-0925-004 · OMB 0925-0753.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0753 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Final Video Submission Posting Form (Attachment B50) Form
Form 1 Final Video Submission Posting Form (Attachment B50) Form
1 CIRB Final Video Submission Attachment B50_CIRB_FinalVideoSubmission_Posting_Form_01AUG2023.docx Form
1 CIRB Final Video Submission Attachment B50_CIRB_FinalVideoSubmission_Posting_Form_01AUG2023.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Final Video Submission Posting Form (Attachment B50)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	CIRB Final Video Submission	Attachment B50_CIRB_FinalVideoSubmission_Posting_Form_01AUG2023.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	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.