MASTER FACILITY INVENTORY--COMPLEMENT SURVEY

ICR 198012-0937-004

OMB: 0937-0027

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
166004
Migrated
ICR Details
0937-0027 198012-0937-004
Historical Active 197912-0937-001
HHS/OASH
MASTER FACILITY INVENTORY--COMPLEMENT SURVEY
No material or nonsubstantive change to a currently approved collection   No
Emergency 12/27/1980
Approved with change 12/27/1980
Retrieve Notice of Action (NOA) 12/27/1980
  Inventory as of this Action Requested Previously Approved
03/31/1981 03/31/1981 12/31/1980
300 0 300
75 0 75
0 0 0

THIS SURVEY EVALUATED THE COMPLETENESS OF COVERAGE OF NCH'S MASTER FACILITY INVENTORY (OMB NO. 68-R1200) AND IS BEING DONE IN CONJUNCTION WITH FIELD WORK FOR THE NATIONAL MEDICAL CARE UTILIZATION AND EXPENDITURE SURVEY (OMB NO. 68-R1687). NCHS WILL USE THE RESULTS TO ESTIMATE THE NUMBER OF FACILITIES NOT INCLUDED IN THE MASTER FACILITY INVENTORY.

None
None


No

1
IC Title Form No. Form Name
MASTER FACILITY INVENTORY--COMPLEMENT SURVEY

  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 300 300 0 0 0 0
Annual Time Burden (Hours) 75 75 0 0 0 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.
12/27/1980


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