View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 3220-0086	ICR Reference No: 197907-3220-014
Status: Historical Active	Previous ICR Reference No: 197405-3220-003
Agency/Subagency: RRB	Agency Tracking No:
Title: APPLICATION FOR REIMBURSEMENT FOR HOSPITAL INSURANCE SERVICE S FURNISHED IN CANADA
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/30/1979
	Date Received in OIRA: 07/30/1979
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1979	09/30/1979
Responses	600	0	0
Time Burden (Hours)	100	0	0
Cost Burden (Dollars)	0	0	0

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.