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Federal forms, ICRs, and supporting documents

Information Collection

Attachment F – Interviews with Partner Hospitals that withdraw

IC 241334 under ICR 202004-0935-002 · OMB 0935-0252.

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Attachment F – Interviews with Partner Hospitals that withdraw
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Attachment F. Interviews with Partner Hospitals that withdraw (2020-01-08).docx Yes Yes Fillable Fileable

Health Health Care Services

 

9 0
   
Private Sector Businesses or other for-profits
 
   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 9 0 9 0 0 0
Annual IC Time Burden (Hours) 3 0 3 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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