Information Collection

_HRSA RWHAP COVID-19 Data Report

IC 241923 under ICR 202005-0906-002 · OMB 0906-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0053 can be found here:

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Information Collection (IC) Details

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IC Title:	_HRSA RWHAP COVID-19 Data Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,045	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	24,540	24,540
Annual IC Time Burden (Hours)	49,080	49,080
Annual IC Cost Burden (Dollars)	0	0

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