Information Collection

Designated Entry Provisions of MDS -- Section 21.960

IC 30544 under ICR 199811-3060-010 · OMB 3060-0658.

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IC Title:

Designated Entry Provisions of MDS -- Section 21.960

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.	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: 75

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	75	-475	550
Annual IC Time Burden (Hours)	75	-975	1,050
Annual IC Cost Burden (Dollars)	4,000	4,000	0

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