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Health Systems Agency Application Guidelines For Designation And Related Reporting Requirements

IC 110262 under ICR 198511-0915-001 · OMB 0915-0085.

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HEALTH SYSTEMS AGENCY APPLICATION GUIDELINES FOR DESIGNATION AND RELATED REPORTING REQUIREMENTS
 
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 HRA 217 No No
Form 217-2 No No


    

131 0
   
State, Local, and Tribal Governments
 
   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 131 0 0 0 0 131
Annual IC Time Burden (Hours) 6,550 0 0 0 0 6,550
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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