Hospital Campaign Activity Scorecard

National Hospital Organ Donation Campaign's Activity Scorecard

OMB: 0915-0373

IC ID: 209057

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Hospital Campaign Activity Scorecard
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Redline Current Approved ChallengeScorecard (REDLINED).docx Yes Yes Fillable Fileable
Form and Instruction 1 FINALCleanChallengeScorecard FINALCleanChallengeScorecard.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,250 500
   
State, Local, and Tribal Governments
 
   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 1,250 0 250 0 0 1,000
Annual IC Time Burden (Hours) 459 0 92 0 0 367
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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