Information Collection

Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program

IC 197986 under ICR 201404-0915-002 · OMB 0915-0342.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0342 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program	Form
1 Reconciliation Tool for the Teaching Health Center Gradu THCGME Reconciliation Tool Form.docx	Form
THCGME Reconciliation Tool Instructions FINAL.docx Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program - Instructions	IC Document

IC Title:

Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program	THCGME Reconciliation Tool Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 44

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	44	-7	51
Annual IC Time Burden (Hours)	88	-167	255
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program - Instructions	THCGME Reconciliation Tool Instructions FINAL.docx	04/09/2014

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