Annual Recertification for Other Entities

340B Drug Pricing Program Forms

OMB: 0915-0327

IC ID: 190352

Information Collection (IC) Details

View Information Collection (IC)

Annual Recertification for Other Entities
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 2 RW-Recertification-Revised RW-Recertification-Revised.pdf Yes Yes Fillable Fileable
Form and Instruction 1 Conmmunity Health Center Recert Conmmunity Health Center Recert.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

2,474 730
   
Private Sector Not-for-profit institutions
 
   100 %

  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 2,474 0 -3,207 0 0 5,681
Annual IC Time Burden (Hours) 619 0 -2,222 0 0 2,841
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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