PROGRESS REPORT FOR HMO PLANNING AND DEVELOPMENT ACTIVITIES

ICR 197612-0937-002

OMB: 0937-0013

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0937-0013 197612-0937-002
Historical Active 197411-0937-002
HHS/OASH
PROGRESS REPORT FOR HMO PLANNING AND DEVELOPMENT ACTIVITIES
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
500 0 600
2,000 0 2,400
0 0 0



None
None


No

1
IC Title Form No. Form Name
PROGRESS REPORT FOR HMO PLANNING AND DEVELOPMENT ACTIVITIES HSA-254

  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 500 600 0 0 -100 0
Annual Time Burden (Hours) 2,000 2,400 0 0 -400 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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