Annual Recertificaion for STD & TB

340B Drug Pricing Program Forms

OMB: 0915-0327

IC ID: 190351

Documents and Forms
Document Name
Document Type
Other-Screenshot for electronic re-c
Information Collection (IC) Details

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Annual Recertificaion for STD & TB
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screenshot for electronic re-certification Recertification Information.doc Yes Yes Fillable Fileable

Health Health Care Services

 

111 0
   
State, Local, and Tribal Governments
 
   0 %

  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 1,221 0 0 0 0 1,221
Annual IC Time Burden (Hours) 101 0 0 0 0 101
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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