Information Collection

Initial Course Application

IC 184870 under ICR 201403-0920-007 · OMB 0920-0138.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0138 can be found here:

Documents and Forms

Document Name Document Type
Initial Course Application Form
Initial Course Application Attachment 3.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Initial Course Application	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	none	Initial Course Application	Attachment 3.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	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.