OMB
.report
Search
FEHB/ FEGLI Implementation Questionnaire for Urban Indian Organizations
DISTRIBUTION OF FEHB/FEGLI IMPLEMENTATION QUESTIONNAIRES TO TRIBES AND URBAN INDIAN ORGANIZATIONS
OMB: 3206-0251
IC ID: 194787
OMB.report
OPM
OMB 3206-0251
ICR 201010-3206-004
IC 194787
( )
Documents and Forms
Document Name
Document Type
Form 0
FEHB/ FEGLI Implementation Questionnaire for Urban Indian Organizations
Form and Instruction
0 FEHB/ FEGLI Implementation Questionnaire for Urban India
IHS - FEHB Urbans_10-4-10_DRAFT.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
FEHB/ FEGLI Implementation Questionnaire for Urban Indian Organizations
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0
FEHB/ FEGLI Implementation Questionnaire for Urban Indian Organizations
IHS - FEHB Urbans_10-4-10_DRAFT.doc
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
65
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
65
0
65
0
0
0
Annual IC Time Burden (Hours)
22
0
22
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.