Information Collection

Health Center Controlled Networks Progress Report

IC 182775 under ICR 200711-0915-002 · OMB 0915-0315.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.