Information Collection

Field Test Of A Long Term Care Data Set In Selected Sites

IC 112291 under ICR 198012-0937-001 · OMB 0937-0081.

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Information Collection (IC) Details

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IC Title:	FIELD TEST OF A LONG TERM CARE DATA SET IN SELECTED SITES	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 290	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,590	3,590
Annual IC Time Burden (Hours)	3,590	3,590
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.