REPORTING REQUIREMENTS FOR HMO FEASIBILITY GRANTEES

ICR 197612-0937-001

OMB: 0937-0012

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
112205 Migrated
ICR Details
0937-0012 197612-0937-001
Historical Active 197411-0937-001
HHS/OASH
REPORTING REQUIREMENTS FOR HMO FEASIBILITY GRANTEES
Revision of a currently approved collection   No
Regular
Approved without change 02/07/1977
Retrieve Notice of Action (NOA) 12/02/1976
  Inventory as of this Action Requested Previously Approved
06/30/1977 06/30/1977 12/31/1976
240 0 400
960 0 1,600
0 0 0



None
None


No

1
IC Title Form No. Form Name
REPORTING REQUIREMENTS FOR HMO FEASIBILITY GRANTEES 0927

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 240 400 0 0 -160 0
Annual Time Burden (Hours) 960 1,600 0 0 -640 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/02/1976


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