OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Individualized Quality Control Plan Workbook Survey

IC 227194 under ICR 201606-0920-007 · OMB 0920-0974.

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

View Information Collection (IC)

Individualized Quality Control Plan Workbook Survey 0920-17AQI
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Online 03_IQCPEpiInfosurveytool_05-04-2017.pdf Yes Yes Fillable Fileable
Other-Email 02_Invitation to participate IQCP 05-04-2017.docx Yes Yes Printable Only

Health Health Care Services

 

500 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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 84 0 84 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval 01_Request for approval form IQCP05-04-2017.docx 06/15/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.