OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Adult Heart and HeartLung Status 1-6 Justification Form Demographic Data

IC 276050 under ICR 202508-0906-005 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 129
Adult Heart and HeartLung Status 1-6 Justification Form Demographic Data Adult Heart and HeartLung Status 1-6 Justification Form Demographic Data		 Form
129. Adult Heart and HeartLung Status 1-6 Justification Form Demographic Data_Instructions.docx Instruction
129 Adult Heart and HeartLung Status 1-6 Justification Form
129. Adult Heart and HeartLung Status 1-6 Justification Form Demographic Data_Form.xlsx 		Form

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 129 Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable

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 20,231 0 20,231 0 0 0
Annual IC Time Burden (Hours) 6,474 0 6,474 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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