Information Collection

NHDS - 2010 & 2011 Sample listing sheet

IC 186293 under ICR 201102-0920-003 · OMB 0920-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment O National Survey Sampling listing sheet redesign.doc	Other-2010 & 2011 Sample listing she
Attachment P National Survey PATIENT ABSTRACT 6-27-08.doc Attachment P - Patient Discharge Abstraction Form	IC Document

IC Title:

NHDS - 2010 & 2011 Sample listing sheet

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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
Other-2010 & 2011 Sample listing sheet			Attachment O National Survey Sampling listing sheet redesign.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health Resources Utilization Statistics

FR Citation: 49 FR 37697

Number of Respondents: 160

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-19,200	19,200
Annual IC Time Burden (Hours)	-4,480	4,480
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment P - Patient Discharge Abstraction Form	Attachment P National Survey PATIENT ABSTRACT 6-27-08.doc	07/24/2008

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