HRSA 99-5 (Initial and Reconciliation)

Children's Hospital Graduate Medical Eduction Program

OMB: 0915-0247

IC ID: 211220

Information Collection (IC) Details

View Information Collection (IC)

HRSA 99-5 (Initial and Reconciliation)
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 99-5 I & R HRSA 99-5 (Initial and Reconciliation) HRSA 99-5 (Initial and Reconciliation).docx Yes Yes Fillable Fileable

Health Health Care Services

 

60 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 120 0 0 0 0 120
Annual IC Time Burden (Hours) 40 0 0 -146 0 186
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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