Information Collection

Cost Study Resource Use and Cost Inventory Tool – Partner/Site Level

IC 241440 under ICR 202003-0920-010 · OMB 0920-1311.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1311 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cost Study Resource Use and Cost Inventory Tool – Partner/Site Level	Form and Instruction
Resource Use and Cost Inventory Tool Att 5b. Cost Resource Use_Inven Tool CatB_Site.xlsx	Form and Instruction

IC Title:

Cost Study Resource Use and Cost Inventory Tool â Partner/Site Level

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Resource Use and Cost Inventory Tool	Att 5b. Cost Resource Use_Inven Tool CatB_Site.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	17	17
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	1,870	1,870

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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