Information Collection

25 CFR 36.97(c) - Parents/guardians waive non-emergency services

IC 181382 under ICR 201906-1076-004 · OMB 1076-0164.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0164 can be found here:

Documents and Forms

Document Name Document Type
25 CFR 36.97(c) - Parents/guardians waive non-emergency services Form and Instruction
Authorization of Medical Care of a Minor 25 CFR Part 36.97C BIE Autorization of Medical Care of a Minor GUIDANCE DOCUMENT.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	25 CFR 36.97(c) - Parents/guardians waive non-emergency services	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 36.97(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Authorization of Medical Care of a Minor	25 CFR Part 36.97C BIE Autorization of Medical Care of a Minor GUIDANCE DOCUMENT.docx		Yes	Yes	Printable Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	3	3
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.