Information Collection

NASA TREAT Astronauts Act

IC 235920 under ICR 202606-2700-004 · OMB 2700-0171.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2700-0171 2026 Screenshots.docx	Other-Screenshots
2700-0171 2026 Text.pdf	Other-Text

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
Other-Screenshots					Yes	Yes	Fillable Fileable
Other-Text					Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title: Health Information Management System 10 HIMS

FR Citation: 88 FR 69961

Number of Respondents: 175

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	4,375	4,375

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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