Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Provider Enrollment Form	Unchanged	31979	4252	16629	Form and Instruction	OWCP-1168	Provider Enrollment Form
Provider Enrollment Form	Unchanged	31979	4252	16629	Form and Instruction	OWCP-1168 Web version screen shots	Provider Enrollment For, Screen Shots
Total burden requested under this ICR:		31979	4252	16629
To view an IC, click on IC Title