Information Collection

Indian Health Service Contract Health Service Report

IC 46026 under ICR 200611-0917-001 · OMB 0917-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0002 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Indian Health Service Contract Health Service Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 136.24

Information Collection 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: 13,717	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	13,717	13,717
Annual IC Time Burden (Hours)	686	686
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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