Commerce Renews HAVANA Act Eligibility Form for About 20 Applicants
Published Date: 10/30/2026
Notice
Summary
The Department of Commerce is renewing a form that helps people apply for HAVANA Act payments, which support those affected by certain health issues. About 20 folks and their doctors will spend about an hour filling it out to see if they qualify. You’ve got 30 more days to share your thoughts before the form gets final approval—no money changes yet, just smoother paperwork!
Analyzed Economic Effects
4 provisions identified: 1 benefits, 3 costs, 0 mixed.
Form to Start HAVANA Act Claim
The Department of Commerce is renewing the Eligibility Questionnaire (Form CD-350) so that any Department covered employee, covered individual, or covered dependent can begin an application for a HAVANA Act one-time payment by completing the form available at www.commerce.gov/havana-act. The OMB control number for the form is 0690-0037.
Physician Must Be Board-Certified
A physician completing Section II of the Eligibility Questionnaire must be currently certified with one of these boards: the American Board of Psychiatry and Neurology (ABPN), the American Osteopathic Board of Neurology and Psychiatry (AOBNP), the American Board of Physical Medicine and Rehabilitation (ABPMR), or the American Osteopathic Board of Physical Medicine and Rehabilitation (AOBPMR).
Time Burden to Complete Form
The notice estimates 20 respondents will complete the Eligibility Questionnaire, with an average of 1 hour per response (30 minutes for the claimant and 30 minutes for the physician), resulting in 20 total burden hours for this collection (OMB Control Number 0690-0037).
Payments Are One-Time
The information collection is for claims that the Department lists as a 'One-time payment' frequency for HAVANA Act payments, meaning the form is used to initiate a single payment event rather than recurring payments.
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