PROGRESS REPORT - HMO FEASIBILITY ACTIVITIES

ICR 197708-0937-001

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
112206 Migrated
ICR Details
0937-0012 197708-0937-001
Historical Active 197612-0937-001
HHS/OASH
PROGRESS REPORT - HMO FEASIBILITY ACTIVITIES
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 09/07/1977
Retrieve Notice of Action (NOA) 08/31/1977
  Inventory as of this Action Requested Previously Approved
12/31/1981 12/31/1981
160 0 0
80 0 0
0 0 0

THIS REPORT WILL FOLLOW THE PROGRESS OF A GIVEN GRANT IN THE BUDGET PERIOD ALLOTED, AND WILL BE BENEFICIAL TO REGIONAL AS WELL AS CENTRAL OFFICE PERSONNEL IN FOLLOWING THEIR PROGRESS. THE INFORMATION IS USED TO ASSESS GRANTEE PROGRESS, IDENTIFY PROBLEM AREAS, DEVELOP A PLAN FOR CORRECTIVE ACTION, AND TO UNIFORMLY TRACK ALL GRANTEES IN COMPLIANCE WITH LEGISLATION, P.L. 93-222 (SECTION 1315). THE REGIONAL OFFICE ALSO ADDS THEIR INTERPRETATION AND COMMENTS TO THIS REPORT

None
None


No

1
IC Title Form No. Form Name
PROGRESS REPORT - HMO FEASIBILITY ACTIVITIES HSA 255

  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 160 0 0 0 160 0
Annual Time Burden (Hours) 80 0 0 0 80 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.
08/31/1977


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