Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medical Clearance Process for Deployment to the Polar Regions Removed 0 0 0
NSF 1421-A, Medical Risks for NSF-Sponsored Personnel Traveling to Antarctica New 3500 1750 0 Form and Instruction 1421-A
NSF 1421-B, Medical Risks for NSF- Sponsored Personnel Traveling to the Polar Regions - Arctic New 100 50 0 Form and Instruction 1421
NSF 1422, Polar Physical Examination - Medical History - Antarctica New 3600 3600 0 Form and Instruction 1422
NSF 1423-A, Polar Physical Examination - Antarctica New 3470 20820 0 Form and Instruction 1423-A
NSF 1423-B, Polar Physical Examination New 100 600 0 Form and Instruction 1423-B
NSF 1423-C, Polar Physical Examination New 30 180 0 Form and Instruction 1423-C
NSF 1424, Medical Screening for Blood-Borne Pathogens/Consent for HIV Antibody Blood Test New 3600 315 0 Form and Instruction 1424
NSF 1425-A, Polar Dental Examination - Antarctica New 3500 7000 0 Form and Instruction 1425-A
NSF 1425-B, Polar Dental Examination - Arctic New 100 200 0 Form and Instruction 1425-B
NSF 1427, Authorization for Treatment of Field-Team Member/Participant Under the Age of 18 Years New 2 0 0 Form and Instruction 1427
NSF 1428-A, Request for Waiver of NSF/OPP Medical Requirements-Antarctica New 30 30 0 Form and Instruction 1428-A
NSF 1428-B, Request for Waiver of NSF/OPP Medical Requirements-Arctic New 1 1 0 Form and Instruction 1428-B
NSF 1429-A, Employer Statement of Support for Waiver Request-Antarctic New 30 30 0 Form and Instruction 1429-A
NSF 1429-B, Employer Statement of Support for Waiver Request-Arctic New 1 1 0 Form and Instruction 1429-B
NSF 1429-I, Individual Statement of Sujpport New 1 0 0 Form and Instruction 1429-I
NSF 1457, Important Notice for Participants in the United States Antarctic Program New 3500 875 0 Form and Instruction 1457
NSF 1458, Personal Information Form New 3500 875 0 Form and Instruction 1458
NSF 1461, Privacy Notice, Antarctica New 3500 420 0 Form and Instruction 1461
Privacy Notice - Arctic New 100 12 0 Other-Privacy Notice for Potential Participants
Privacy Notice, Antarctica New 3500 420 0 Other-Privacy Notice for Potential Participants
Total burden requested under this ICR: 32165 37179 0  
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