Information Collection

LTC Staff and Personnel Impact - microbiologist

IC 241487 under ICR 202008-0920-012 · OMB 0920-1290.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
LTC Staff and Personnel Impact LTC Staff and Personnel Impact - microbiologist	Form
LTC Staff and Personnel Impact LTC_STAFF IMPACTv2 042320.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	none				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,782

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	254,332	254,332
Annual IC Time Burden (Hours)	63,583	63,583
Annual IC Cost Burden (Dollars)	0	0

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.

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