Information Collection

Professional Standards Review Organization Routine Federal Reporting Requirements

IC 112726 under ICR 198203-0938-001 · OMB 0938-0063.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

PROFESSIONAL STANDARDS REVIEW ORGANIZATION ROUTINE FEDERAL REPORTING REQUIREMENTS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	111	No	No
Form	121	No	No
Form	121-B,	No	No
Form	135,	No	No
Form	153Q,	No	No
Form	153A	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,695

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	22,680	22,680
Annual IC Time Burden (Hours)	65,137	65,137
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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