Information Collection

Screener Round, National Nursing Home Expenditure Survey, National Medical Expenditure Survey-pretest

IC 165974 under ICR 199503-0935-001 · OMB 0935-0094.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

SCREENER ROUND, NATIONAL NURSING HOME EXPENDITURE SURVEY, NATIONAL MEDICAL EXPENDITURE SURVEY-PRETEST

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 430

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	443	300	143
Annual IC Time Burden (Hours)	62	50	12
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.