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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.