Information Collection

Certificate Of Need For Health Facility And Assurance Of Enforcement Of State Standards

IC 173563 under ICR 198906-2502-009 · OMB 2502-0210.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	CERTIFICATE OF NEED FOR HEALTH FACILITY AND ASSURANCE OF ENFORCEMENT OF STATE STANDARDS	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
Form	HUD 2576-HF				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	3,020	3,020
Annual IC Cost Burden (Dollars)	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.