Health Center Controlled Networks Progress Report

Health Center Controlled Networks Progress Reports

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0315 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Health Center Controlled Networks Progress Report Form
1 Progress Report FINALProgress Report Template Nov 5.doc Form
FINALInstructions Nov 5.doc Instructions IC Document

Information Collection (IC) Details

IC Title:	Health Center Controlled Networks Progress 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:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Progress Report	FINALProgress Report Template Nov 5.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 46	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	92	92
Annual IC Time Burden (Hours)	552	552
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Instructions	FINALInstructions Nov 5.doc	11/09/2007

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