Information Collection

Information Collection Requirements Contained in 42 CFR Part Obligations

IC 38103 under ICR 199909-0990-001 · OMB 0990-0216.

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IC Title:

Information Collection Requirements Contained in 42 CFR Part Obligations

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: 12

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	12	0	12
Annual IC Time Burden (Hours)	38	0	38
Annual IC Cost Burden (Dollars)	5,000	-4,995,000	5,000,000

Documents for IC

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Title	Document	Date Uploaded

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