Information Collection

Indian Health Service Contract Health Service Reports

IC 6556 under ICR 199609-0917-001 · OMB 0917-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Indian Health Service Contract Health Service Reports

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	64-1A	No	No
Form	57-1A	No	No
Form	IHS-43-1A	No	No
Form	843-1A	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,200

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
Annual Number of Responses for this IC	591,026	591,026
Annual IC Time Burden (Hours)	61,821	61,821
Annual IC Cost Burden (Dollars)	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.