APPLICATION FOR FEDERAL ASSISTANCE FOR ESRD NETWORK COORDINATING COUNCIL

ICR 198012-0938-001

OMB: 0938-0139

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0139 198012-0938-001
Historical Active
HHS/CMS
APPLICATION FOR FEDERAL ASSISTANCE FOR ESRD NETWORK COORDINATING COUNCIL
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 03/07/1981
Retrieve Notice of Action (NOA) 12/19/1980
The "Application Requirements and Instructions" shall require (under "Organizational Documents") position descriptions only for key staff and not for "all staff." The "Detailed Breakdown for Furniture and Equiptment" is disapproved. Within these two restrictions the remainder of the request for clearance is approved.
  Inventory as of this Action Requested Previously Approved
12/31/1982 12/31/1982
32 0 0
3,200 0 0
0 0 0

THIS FORM, WHICH IS REQUIRED BY PROPOSED REGULATIONS, WILL BE USED BY THE COORDINATING COUNCILS OF EACH OF THE 32 END STAGE RENAL DISEASE (ESRD) NETWORKS TO APPLY FOR FEDERAL FUNDING.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR FEDERAL ASSISTANCE FOR ESRD NETWORK COORDINATING COUNCIL HCFA-1518

  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 32 0 0 32 0 0
Annual Time Burden (Hours) 3,200 0 0 3,200 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
12/19/1980


© 2024 OMB.report | Privacy Policy