Information Collection

Inventory Survey

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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.