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USM-602 Contract Guard Physical Examination Report
USMS Medical Forms
OMB: 1105-0099
IC ID: 229431
OMB.report
DOJ/LA
OMB 1105-0099
ICR 202406-1105-004
IC 229431
( )
Documents and Forms
Document Name
Document Type
Form USM-602
USM-602 Contract Guard Physical Examination Report
Form and Instruction
USM-602 Contract Guard Physical Examination Report
Form USM-602, Contract Guard Physical Examination Report.pdf
Provided directly to those who need to use it
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
USM-602 Contract Guard Physical Examination Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
USM-602
Contract Guard Physical Examination Report
Form USM-602, Contract Guard Physical Examination Report.pdf
Provided directly to those who need to use it
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
OPMGOVT-1, General Personnel Records
FR Citation:
76 FR 32997
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
500
0
0
0
500
0
Annual IC Time Burden (Hours)
1,250
0
0
0
1,250
0
Annual IC Cost Burden (Dollars)
46,713
0
0
0
46,713
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.