Information Collection

Inventory Survey

IC 187920 under ICR 200901-0935-001 · OMB 0935-0149.

Documents and Forms

Document Name Document Type
Form Form 1 Inventory Survey Form and Instruction
Form 1 AHRQ Inventory Survey Attachment C -- Data Collection Instrument.doc Form and Instruction
Attachment D -- E-mail Reminder.doc Attachment D -- E-mail Reminder IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Inventory Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 1	AHRQ Inventory Survey	Attachment C -- Data Collection Instrument.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment D -- E-mail Reminder	Attachment D -- E-mail Reminder.doc	01/02/2009

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