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Children's Hospital GME Annual Report Program Information
Children's Hospital Graduate Medical Education Program Annual Report
OMB: 0915-0313
IC ID: 182196
OMB.report
HHS/HSA
OMB 0915-0313
ICR 201008-0915-003
IC 182196
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0313 can be found here:
2013-08-07 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
FY2011 CHGME Anual Report Guidance final draft _4_.pdf
Instruction
FY2011_chgme_100-4.pdf
Other-certification
FY2011_chgme_100-5.pdf
Other-checklist
FY2011 HRSA 100-4 10_29-10.pdf
Other-Certification
FY2011 HRSA 100-5 10_29_10.pdf
Other-Checklist
chgme 100-2 chgme 100-2
FY2011_HRSA100-2.xls
Form
chgme_100-3 chgme_100-3
FY2011_HRSA100-3.xls
Form
HRSA100-2 FY2011 HRSA100-2 10_29_10
FY2011 HRSA100-2 10_29_10.xls
Form
HRSA100-3 FY2011 HrSA100-3 10_29_10
FY2011 HRSA100-3 10_29_10.xls
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Children's Hospital GME Annual Report Program Information
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
Other-checklist
FY2011_chgme_100-5.pdf
Yes
Yes
Fillable Fileable
Instruction
FY2011 CHGME Anual Report Guidance final draft _4_.pdf
Yes
Yes
Fillable Fileable
Other-certification
FY2011_chgme_100-4.pdf
Yes
Yes
Fillable Fileable
Form
chgme 100-2
chgme 100-2
FY2011_HRSA100-2.xls
Yes
Yes
Fillable Fileable
Form
chgme_100-3
chgme_100-3
FY2011_HRSA100-3.xls
Yes
Yes
Fillable Fileable
Form
HRSA100-2
FY2011 HRSA100-2 10_29_10
FY2011 HRSA100-2 10_29_10.xls
Yes
Yes
Fillable Fileable
Form
HRSA100-3
FY2011 HrSA100-3 10_29_10
FY2011 HRSA100-3 10_29_10.xls
Yes
Yes
Fillable Fileable
Other-Certification
FY2011 HRSA 100-4 10_29-10.pdf
Yes
Yes
Fillable Fileable
Other-Checklist
FY2011 HRSA 100-5 10_29_10.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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
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
56
0
0
-1
0
57
Annual IC Time Burden (Hours)
4,407
0
0
143
0
4,264
Annual IC Cost Burden (Dollars)
0
0
0
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.