Information Collection

FSR 245 HHS CMS NGS, FSR 246 DOD Navy

IC 187826 under ICR 200807-1505-001 · OMB 1505-0186.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FSR 245 FSR 245 HHS CMS NGS, FSR 246 DOD Navy	Form
FSR 245 HHS CMS NGS questionnaire FSR 245 HHS CMS NGS.xls	Form
FSR 246 DOD Navy questionnaire FSR 246 DOD Navy.xls	Form
Justification for ICs to generic ICR 1505-0186.doc Justification for ICs to generic ICR 1505-0186.doc	IC Document

IC Title:

Agency IC Tracking Number:

FSR 245, FSR 246

IC Status: New

Obligation to Respond: Voluntary

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	FSR 245	HHS CMS NGS questionnaire	FSR 245 HHS CMS NGS.xls		Yes	Yes	Fillable Fileable
Form	FSR 246	DOD Navy questionnaire	FSR 246 DOD Navy.xls		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	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	10,000	0	0	0	0	0
Annual IC Time Burden (Hours)	417	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for ICs to generic ICR 1505-0186.doc	Justification for ICs to generic ICR 1505-0186.doc	01/16/2009

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