Information Collection

(EGAPP) - Purchaser Survey - att D3

IC 179075 under ICR 200703-0920-005 · OMB 0920-0751.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0751 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment D3 HealthCare Purchaser Survey (EGAPP) - Purchaser Survey - att D3	Form and Instruction
Attachment D3 HealthCare Purchaser Survey Attachment D3 Health Care Pruchaser Survey.doc	Form and Instruction

IC Title:

(EGAPP) - Purchaser Survey - att D3

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Form and Instruction	None				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	31	31
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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