View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0772	ICR Reference No: 201401-0960-003
Status: Historical Active	Previous ICR Reference No: 201012-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Medical Treatment in an SSA Employee Health Facility: Patient Self-Administered or Staff Administered Care
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/16/2014
	Date Received in OIRA: 04/30/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	175	0	175
Time Burden (Hours)	15	0	15
Cost Burden (Dollars)	0	0	0

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