Information Collection

Att 4a_Exploratory Testing Guide_Prevention with Positives & Retentiuon in Care

IC 223931 under ICR 201610-0920-007 · OMB 0920-1182.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1182 can be found here:

Documents and Forms

Document Name Document Type
Att 4a Exp Guide-PwPRetentioninCare.docx Other-WORD

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att 4a_Exploratory Testing Guide_Prevention with Positives & Retentiuon in Care	Agency IC Tracking Number:	16TZ

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Att 4a Exp Guide-PwPRetentioninCare.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.