OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Single Audit Form Completion Test Model

IC 223089 under ICR 201603-4040-001 · OMB 4040-0017.

Documents and Forms
Document Name
Document Type
Other-questionnaire
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Single Audit Form Completion Test Model
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-questionnaire HHS DAP_Single Audit Questionnaire_08112016.docx Yes Yes Fillable Fileable

Health Health Care Services

 

42 0
   
Private Sector Businesses or other for-profits, 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 42 0 42 0 0 0
Annual IC Time Burden (Hours) 11 0 11 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Short SS REVISED_4040-0017_Short Supporting Statement_Single Audit SEFA_081716.docx 08/17/2016
Suppt. st A 4040-0017_Supporting Statement A_Single Audit SEFA_08112016.docx 08/17/2016
audit form completion HHS DAP_Single Audit Form Completion_08112016.pptx 08/17/2016
instructions HHS DAP_Single Audit Form Completion_Instruction Manual_08112016.docx 08/17/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.