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Information Collection

Outline For Obtaining Information As To Suitability Of Home Other Than Patients Own

IC 174220 under ICR 198210-2900-011 · OMB 2900-0082.

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OUTLINE FOR OBTAINING INFORMATION AS TO SUITABILITY OF HOME OTHER THAN PATIENTS OWN
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-2408 No No


    

3,400 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,400 0 0 0 0 3,400
Annual IC Time Burden (Hours) 567 0 -933 0 0 1,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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