Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Additional Documentation and Certification Modified 324 243 0 Form 3
Authorization for Use or Disclosure of Health Information Form Modified 360 720 0 Form 2
Benefits Package and Supporting Documentation Modified 30 300 0 Instruction
Form Survivor - Form 2
Form Survivor - Attachment 1
Form Survivor - Form 3
Form Survivor - Form 1
Instruction
Instruction
Instruction
Form Estate - 1
Form Estate - 2
Form Recipient - 1
Form Recipient - 2
Countermeasures Injury Compensation Program Request Package Modified 360 3960 0 Instruction
Form 1
Total burden requested under this ICR: 1074 5223 0  
To view an IC, click on IC Title