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Health Center (administrative professional)
Safe Harbor for Federally Qualified Health Centers Arrangements
OMB: 0990-0322
IC ID: 182767
OMB.report
HHS/HHSDM
OMB 0990-0322
ICR 200711-0990-001
IC 182767
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0322 can be found here:
2015-01-26 - Reinstatement without change of a previously approved collection
2011-07-05 - Reinstatement without change of a previously approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Health Center (administrative professional)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
5 CFR 1320.5
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,873
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,873
0
1,873
0
0
0
Annual IC Time Burden (Hours)
1,873
0
1,873
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.