HRSA Client-Level Data Reporting System: Grantee Report

HRSA HAB Client-Level Data Reporting System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0323 can be found here:

Documents and Forms

Document Name Document Type
Form 1 HRSA Client-Level Data Reporting System: Grantee Report Form
1 HRSA Client-Level Data Reporting System: Grantee Report 2 RSR_Grantee_Report_Screenshots.docx Form

Information Collection (IC) Details

IC Title:	HRSA Client-Level Data Reporting System: Grantee Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	HRSA Client-Level Data Reporting System: Grantee Report	2 RSR_Grantee_Report_Screenshots.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 595	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	595	28	567
Annual IC Time Burden (Hours)	4,165	3,757	408
Annual IC Cost Burden (Dollars)	0	0	0

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.