Information Collection

IHS Urban Indian Health Program Common Reporting Requirements

IC 6565 under ICR 201108-0917-001 · OMB 0917-0007.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0917-0007 IHS Urban Indian Health Program Common Reporting Requirements	Form and Instruction
0917-0007 UDS Reporting Instructions for OUIHP Programs 2010 UIHP Manual _2011Feb 17 2011 final.doc	Form and Instruction

IC Title:

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 and Instruction	0917-0007	UDS Reporting Instructions for OUIHP Programs	2010 UIHP Manual _2011Feb 17 2011 final.doc		No	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 33

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	33	33
Annual IC Time Burden (Hours)	792	792
Annual IC Cost Burden (Dollars)	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.