Information Collection

2004 National Long-Term Care Survey (NLTCS); Informal Caregivers Survey (ICS)

IC 3506 under ICR 200407-0607-002 · OMB 0607-0778.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

IC Title:

2004 National Long-Term Care Survey (NLTCS); Informal Caregivers Survey (ICS)

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.	Available Electronically?	Can Be Submitted Electronically?
Form	LTC-9(L4)	Yes	Yes
Form	LTC-9(L2)	Yes	Yes
Form	LTC-4	Yes	Yes
Form	LTC-9(L3)	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19,900

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32,300	32,300
Annual IC Time Burden (Hours)	9,891	9,891
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.