Information Collection

Web Sites (sections 435.1200 and 457.335)

IC 199159 under ICR 201812-0938-021 · OMB 0938-1147.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1147 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Web Sites (sections 435.1200 and 457.335)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 457.335 42 CFR 435.1200

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	122	69	53
Annual IC Time Burden (Hours)	14,766	-11,840	26,606
Annual IC Cost Burden (Dollars)	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.