Information Collection

Initial Registration of Voluntary and Non-regulated Submissions

IC 239356 under ICR 202512-0925-004 · OMB 0925-0586.

Documents and Forms

Document Name Document Type
Form 1 Registration Data Entry Forms Initial Registration of Voluntary and Non-regulated Submissions Form
Form 1 Registration Data Entry Forms Initial Registration of Voluntary and Non-regulated Submissions Form
1 Registration Data Entry Forms Attachment 2 - Registration PRS Data Entry Forms 2_11_2026.pdf Form
1 Registration Data Entry Forms Attachment 2 - Registration PRS Data Entry Forms 2_11_2026.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Initial Registration of Voluntary and Non-regulated Submissions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Registration Data Entry Forms	Attachment 2 - Registration PRS Data Entry Forms 2_11_2026.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 23,130	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	23,130	5,270	17,860
Annual IC Time Burden (Hours)	185,040	42,160	142,880
Annual IC Cost Burden (Dollars)	0	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.

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