Information Collection Request

COVID-19 Data Report

ICR 202011-0906-001 · OMB 0906-0053 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 _HRSA RWHAP COVID-19 Data Report Form Modified Missing upstream
Attachment B - 2020_CDR_Instruction_Manual_08_03_20_508.pdf Supplementary Document Uploaded 2020-11-15 Repair queued
Attachment A - 60 Day FRN.pdf Supplementary Document Uploaded 2020-11-15 Missing upstream
Supporting Statement B.docx Supporting Statement B Uploaded 2020-11-15 Repair queued
Supporting Statement A.docx Supporting Statement A Uploaded 2020-11-15 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
241923 _HRSA RWHAP COVID-19 Data Report Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 01/31/2021
24,540 24,540
78,528 49,080
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
_HRSA RWHAP COVID-19 Data Report 1 Coronavirus 2019 (COVID-19) Data Report Form.docx

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 24,540 24,540 0 0 0 0
Annual Time Burden (Hours) 78,528 49,080 0 29,448 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No