OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Record-keeping for Sterilization Consent Form

IC 191181 under ICR 202501-0937-001 · OMB 0937-0166.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 0937-0166
Record-keeping for Sterilization Consent Form		 Form
Form 0937-0166
Sterilization Consent Form Record-keeping for Sterilization Consent Form		 Form
consent_for_sterilization_spanish_updated form.pdf Other-Form
consent_for_sterilization_spanish_updated form.pdf Other-Form
0937-0166 Sterilization Consent Form
0937-0166 Consent for Sterilization (English) FORM 687.docx 		Form
0937-0166 Sterilization Consent Form
0937-0166 Consent for Sterilization (English) FORM 687.docx 		Form
2024-25748.pdf
60 D FRN Renewal		IC Document
2024-25748.pdf
60 D FRN Renewal		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 0937-0166 No   Printable Only
Other-Form No   Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 100,000 0 0 0 0 100,000
Annual IC Time Burden (Hours) 25,000 0 0 0 0 25,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
60 D FRN Renewal 01/13/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].