Information Collection

Business Proposal Forms For Quality Improvement Organizations (QIOs)

IC 43659 under ICR 200605-0938-005 · OMB 0938-0579.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0579 can be found here:

Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

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IC Title:	Business Proposal Forms For Quality Improvement Organizations (QIOs)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	SC2	Yes
Form	721-BP	Yes	Yes
Form	720-BP	Yes	Yes
Form	SUM	Yes	Yes
Form	STAFFING	Yes	Yes
Form	718-BP	Yes	Yes
Form	719-BP	Yes	Yes
Form	SC1	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	455	455
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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