HAB Client-Level Data Collection System

HAB Client Level Reporting

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0323 can be found here:

Documents and Forms

Document Name Document Type
CLD Collection System_Instruction_Manual.pdf Instruction

Information Collection (IC) Details

IC Title:	HAB Client-Level Data Collection System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CLD Collection System_Instruction_Manual.pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,049	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,366	1,366
Annual IC Time Burden (Hours)	63,382	63,382
Annual IC Cost Burden (Dollars)	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.