Information Collection

Regional Resource Network Program Questionnaire

IC 212148 under ICR 201106-0990-001 · OMB 0990-0379.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0379_RRNP questionnaire 3-26-14v(4 1).docx	Other-questionnaire
0990-0379_Generic_Clearance_Submission_RRNP_06262014.docx Regional Resource Network Program Questionnaire	IC Document

IC Title:

Regional Resource Network Program Questionnaire

Agency IC Tracking Number:

IC Status: New

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-questionnaire			0990-0379_RRNP questionnaire 3-26-14v(4 1).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Regional Resource Network Program Questionnaire	0990-0379_Generic_Clearance_Submission_RRNP_06262014.docx	06/27/2014

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