Information Collection

ONe-time System Deployment

IC 214986 under ICR 201608-0920-007 · OMB 0920-0556.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0556 can be found here:

Documents and Forms

Document Name Document Type
ONe-time System Deployment Form
NASS Att C1b. (Proposed starting 2016) NASS screens_01 22 2015.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ONe-time System Deployment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	NASS	Att C1b. (Proposed starting 2016) NASS screens_01 22 2015.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 149	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	149	149
Annual IC Time Burden (Hours)	5,960	5,960
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.