Information Collection Request

Legacy High-Cost Support Recipient Initial Report of Current Service Offerings

ICR 202106-3060-006 · OMB 3060-1291 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Supporting Statement for New Legacy High-Cost Support Recipient Initial Report_3060-XXXX_3-18-21_FINAL.docx Supporting Statement A Uploaded 2021-06-06 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
247776 Legacy High-Cost Support Recipient Initial Report of Current Service Offerings New
247775 Legacy High-Cost Support Recipient Initial Report of Current Service Offerings Other-Screenshots New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
110 0
1,760 0
0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Legacy High-Cost Support Recipient Initial Report of Current Service Offerings
Legacy High-Cost Support Recipient Initial Report of Current Service Offerings

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 110 0 0 110 0 0
Annual Time Burden (Hours) 1,760 0 0 1,760 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No