Information Collection

IHS Pharmacy Automation Survey 2013

IC 205657 under ICR 201301-0917-001 · OMB 0917-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OMB No. 0917-0036- IHS Pharmacy Automation Survey 2013	Form and Instruction
OMB No. 0917-0036- OMB No. 0917-0036-19, IHS Pharmacy Automation Survey OMB No. 0917-0036-19, IHS Pharmacy Automation Survey.pdf	Form and Instruction
OMB No. 0917-0036-19, Mini-supporting Statement for IHS Pharmacy Automation Survey 2013.doc OMB No. 0917-0036-19, Mini-Suporting Statement for IHS Pharmacy Automation Survey 2013	IC Document

IC Title:

IHS Pharmacy Automation Survey 2013

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
Form and Instruction	OMB No. 0917-0036-19	OMB No. 0917-0036-19, IHS Pharmacy Automation Survey	OMB No. 0917-0036-19, IHS Pharmacy Automation Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB No. 0917-0036-19, Mini-Suporting Statement for IHS Pharmacy Automation Survey 2013	OMB No. 0917-0036-19, Mini-supporting Statement for IHS Pharmacy Automation Survey 2013.doc	01/29/2013

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