Information Collection

Children's Hospital GME Annual Report Screeing Instrument

IC 182195 under ICR 201008-0915-003 · OMB 0915-0313.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0313 can be found here:

Documents and Forms

Document Name Document Type
Form BHPR_CHGME_100-1_F Children's Hospital GME Annual Report Screeing Instrument Form
BHPR_CHGME_100-1_F BHPR_CHGME_100-1_FY2011 Copy_of_FY2011_HRSA100-1_(3)(1).xlsx Form
HRSA100-1 FY2011 HRSA100-1 10-29-10 FY2011 HRSA100-1 10_29_10.xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Children's Hospital GME Annual Report Screeing Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	BHPR_CHGME_100-1_FY2011	BHPR_CHGME_100-1_FY2011	Copy_of_FY2011_HRSA100-1_(3)(1).xlsx		Yes	Yes	Fillable Fileable
Form	HRSA100-1	FY2011 HRSA100-1 10-29-10	FY2011 HRSA100-1 10_29_10.xls		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	56	-1	57
Annual IC Time Burden (Hours)	515	-55	570
Annual IC Cost Burden (Dollars)	0	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.