Information Collection

Innovator review and approval of written profile

IC 212146 under ICR 201406-0935-002 · OMB 0935-0147.

Documents and Forms

Document Name Document Type
Form 4 Innovator review and approval of written profile Form and Instruction
4 Innovator review and approval of written profile Attachment C -- Innovator Interview Guide 11.14.13.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Innovator review and approval of written profile	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	Innovator review and approval of written profile	Attachment C -- Innovator Interview Guide 11.14.13.doc		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	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.