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Individual Notice substitute Notice
HITECH Act Breach Notification
OMB: 0945-0001
IC ID: 190798
OMB.report
HHS/OCR
OMB 0945-0001
ICR 201211-0945-001
IC 190798
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0945-0001 can be found here:
2013-02-22 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Individual Notice substitute Notice
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
45 CFR 160
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
70
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
70
0
0
0
0
70
Annual IC Time Burden (Hours)
240,660
0
0
0
0
240,660
Annual IC Cost Burden (Dollars)
1,015,280
0
0
0
0
1,015,280
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.