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: 198009-3220-013
Status: Historical Active	Previous ICR Reference No: 197908-3220-009
Agency/Subagency: RRB	Agency Tracking No:
Title: APPLICATION FOR REIMBURSEMENT FOR HOSPITAL INSURANCE SERVICE IN CANADA
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 09/23/1980
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/23/1980
	Date Received in OIRA: 09/23/1980
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1980	12/31/1980	09/30/1980
Responses	600	0	600
Time Burden (Hours)	100	0	100
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.