Information Collection

Fire Safety Survey Report Forms and Supporting Regulations in 42 CFR 488.26 and 442.30

IC 7898 under ICR 200401-0938-010 · OMB 0938-0242.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0242 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Fire Safety Survey Report Forms and Supporting Regulations in 42 CFR 488.26 and 442.30

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	2786U	No	No
Form	CMS-2786M	No	No
Form	2786V	No	No
Form	2786Y	No	No
Form	2786T	No	No
Form	2786W	No	No
Form	2786R	No	No
Form	2786S	No	No
Form	2786X	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 27,900

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	27,900	27,900
Annual IC Time Burden (Hours)	2,325	2,325
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.