Information Collection

42 Cfr Part 36, Eligibility For Indian Health Service Services--nprm

IC 110451 under ICR 198806-0917-006 · OMB 0917-0008.

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Information Collection (IC) Details

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IC Title:	42 CFR PART 36, ELIGIBILITY FOR INDIAN HEALTH SERVICE SERVICES--NPRM	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:

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

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Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

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