OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Follow-up Survey for 9 months

IC 226560 under ICR 202007-0990-002 · OMB 0990-0452.

Documents and Forms
Document Name
Document Type
Other-survey
Information Collection (IC) Details

View Information Collection (IC)

Follow-up Survey for 9 months
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey Instrument1_FollowUp_Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

200 0
   
Individuals or Households
 
   100 %

  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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 100 0 0 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.