OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Att 4b_Screener for Men

IC 219988 under ICR 201602-0920-001 · OMB 0920-1113.

Documents and Forms
Document Name
Document Type
Other-null
Information Collection (IC) Details

View Information Collection (IC)

Att 4b_Screener for Men 16CO
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-null Att. 4b - Screener for Men_4 19 2016.docx No   Paper Only

Health Consumer Health and Safety

 

40 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 40 0 40 0 0 0
Annual IC Time Burden (Hours) 7 0 7 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.