Information Collection

340B Program Registrations amp; Certifications for Children's Hospitals

IC 190346 under ICR 201604-0915-002 · OMB 0915-0327.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0327 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 340B Program Registrations amp; Certifications for Children's Hospitals	Form
1 340B Registration Children's Hospital -Revised 340B Registration Children's Hospital -Revised.docx	Form
2 Cert state or local government-Revised Cert state or local government-Revised.docx	Form
3 Public Ownership-Revised.docx Public Ownership-Revised.docx	Form

IC Title:

340B Program Registrations amp; Certifications for Children's Hospitals

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	340B Registration Children's Hospital -Revised	340B Registration Children's Hospital -Revised.docx	Yes	Yes	Fillable Fileable
Form	2	Cert state or local government-Revised	Cert state or local government-Revised.docx	Yes	Yes	Fillable Fileable
Form	3	Public Ownership-Revised.docx	Public Ownership-Revised.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

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
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-30	30
Annual IC Time Burden (Hours)	-60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.