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Federal forms, ICRs, and supporting documents

Information Collection

MUH Resident Baseline Survey - screening LA

IC 204442 under ICR 201309-0920-011 · OMB 0920-1004.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

MUH Resident Baseline Survey - screening LA
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none MUH Resident Survey - LA (English) clean 12.17.13Att 8A(e)_MUH Resident Baseline Survey.doc Yes No Fillable Printable
Form none MUH Resident Survey - LA (Spanish) clean 12.17.13 Att 8A(s)_MUH Resident Baseline Survey_12.15.13.doc Yes No Fillable Printable

Health Immunization Management

 

833 0
   
Individuals or Households
 
   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 833 0 833 0 0 0
Annual IC Time Burden (Hours) 69 0 69 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.