Information Collection

Certificate of Need for Health Facility and Assurance of Enforcement of State Standards

IC 27066 under ICR 200705-2502-003 · OMB 2502-0210.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-2576-HF Certificate of Need for Health Facility and Assurance of Enforcement of State Standards Certificate of Need for Health Facility and Assurance of Enforcement of State Standards	Form
HUD-2576-HF Certificate of Need for Health Facility and Assurance of 2576-hf.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 24 CFR 232

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	HUD-2576-HF				Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
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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