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Annual Report For The Title Iii Long Term Care OMBudsman Program
ANNUAL REPORT FOR THE TITLE III LONG TERM CARE OMBUDSMAN PROGRAM
OMB: 0980-0121
IC ID: 116217
OMB.report
HHS/HDSO
OMB 0980-0121
ICR 198312-0980-003
IC 116217
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0980-0121 can be found here:
1988-03-22 - Reinstatement with change of a previously approved collection
1986-12-24 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ANNUAL REPORT FOR THE TITLE III LONG TERM CARE OMBUDSMAN PROGRAM
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
52
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
52
0
0
0
0
52
Annual IC Time Burden (Hours)
1,287
0
0
1,235
0
52
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.