No Wrong Door System Management Tool-State and Local Level

No Wrong Door System Management Tool

OMB: 0985-0062

IC ID: 234839

Information Collection (IC) Details

View Information Collection (IC)

No Wrong Door System Management Tool-State and Local Level
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA No Wrong Door Management Data Colleciton and Entry Tool NWD System Management Tool.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,052 0
   
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 2,104 0 2,104 0 0 0
Annual IC Time Burden (Hours) 8,080 0 8,080 0 0 0
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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