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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.