Information Collection

Survey on Rural Community Wealth and Health Care Provision - Mail/web survey with health care providers_nonrespondents

IC 202485 under ICR 201310-0536-001 · OMB 0536-0072.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0536-0072 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NON-Response Place Holder_health care provider.doc	Other-Nonresponse place holder_mail

IC Title:

Survey on Rural Community Wealth and Health Care Provision - Mail/web survey with health care providers_nonrespondents

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Nonresponse place holder_mail questionnaire			NON-Response Place Holder_health care provider.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	300	300
Annual IC Time Burden (Hours)	75	75
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.