Information Collection

Hospital And Hospital Health Care Complex Cost Report, Form Hcfa-2552-demo

IC 166334 under ICR 199103-0938-013 · OMB 0938-0559.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0559 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX COST REPORT, FORM HCFA-2552-DEMO	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
Form	2552-DEMO				No	No
Form	HCFA				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 700	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	105,000	105,000
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.