Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents

Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents

OMB: 0660-0027

IC ID: 184582

Information Collection (IC) Details

View Information Collection (IC)

Application for Digital-to-Analog Converter Box Coupons for Nursing Home Residents
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Application for Converter Box Coupons for Nursing Home Residents 0660.Draft Nursing Home Coupon Application.doc Yes Yes Fillable Fileable

General Government Executive Functions

 

13,000,000 0
   
Individuals or Households
 
   50 %

  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 13,000,000 0 13,000,000 0 0 0
Annual IC Time Burden (Hours) 6,500,000 0 6,500,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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