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Supplementary Statement For Graduate Medical Trainees
SUPPLEMENTARY STATEMENT FOR GRADUATE MEDICAL TRAINEES
OMB: 1115-0108
IC ID: 119716
OMB.report
DOJ/INS
OMB 1115-0108
ICR 199108-1115-002
IC 119716
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1115-0108 can be found here:
2002-05-24 - Extension without change of a currently approved collection
1999-03-29 - Reinstatement without change of a previously approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SUPPLEMENTARY STATEMENT FOR GRADUATE MEDICAL TRAINEES
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
I-644
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,000
0
3,000
0
0
0
Annual IC Time Burden (Hours)
249
0
249
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.