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Federal forms, ICRs, and supporting documents

Information Collection

Designation of Medically Underserved Populations and Health Professional Shortage Areas

IC 183981 under ICR 200802-0915-002 · OMB 0915-0317.

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Designation of Medically Underserved Populations and Health Professional Shortage Areas
 
No New
 
Required to Obtain or Retain Benefits
 
42 CFR 5

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction proposed method.doc Yes No Printable Only

Health Health Care Services

 

54 0
   
State, Local, and Tribal Governments
 
   0 %

  Requested 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 391 391 0 0 0 0
Annual IC Time Burden (Hours) 10,713 10,713 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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