Information Collection

Initial Registration of Voluntary and Non-regulated Submissions

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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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				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 %

table that charts list of burden
	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

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.

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