OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Segregation Plan

IC 241135 under ICR 202004-0938-002 · OMB 0938-1358.

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Information Collection (IC) Details

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Segregation Plan
 
No New
 
Required to Obtain or Retain Benefits
 
45 CFR 156.280(e)(5)(ii)

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

Health Health Care Services

 

10 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 10 0 0 10 0 0
Annual IC Time Burden (Hours) 580 0 0 580 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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