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Federal forms, ICRs, and supporting documents

Information Collection Request

REQUEST TO FIRM FOR ESTIMATE OF COST FOR PURCHASE OR REPAIR OF PROSTHETIC APPLIANCES

ICR 198312-2900-004 · OMB 2900-0338 · Historical Active

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IC IDCollectionTypeStatusForm
147971 REQUEST TO FIRM FOR ESTIMATE OF COST FOR PURCHASE OR REPAIR OF PROSTHETIC APPLIANCES Form Migrated
ICR Details
2900-0338 198312-2900-004
Historical Active 198107-2900-003
VA
REQUEST TO FIRM FOR ESTIMATE OF COST FOR PURCHASE OR REPAIR OF PROSTHETIC APPLIANCES
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 01/31/1984
Retrieve Notice of Action (NOA) 12/05/1983
  Inventory as of this Action Requested Previously Approved
09/30/1986 09/30/1986
20,000 0 0
1,600 0 0
0 0 0
THIS FORM IS USED TO SECURE A WRITTEN ESTIMATE FROM COMMERCIAL VENDORS FOR A PRESCRIBED PROSTHETIC SERVICE OR DEVICE.
None
None
No
1
IC Title Form No. Form Name
REQUEST TO FIRM FOR ESTIMATE OF COST FOR PURCHASE OR REPAIR OF PROSTHETIC APPLIANCES FL 10-90
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 20,000 0 0 0 20,000 0
Annual Time Burden (Hours) 1,600 0 0 0 1,600 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/05/1983