OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

42 CFR 50.606(c) or 45 CFR 94.6(c) (Disclosure)

IC 200605 under ICR 202204-0925-001 · OMB 0925-0417.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Information Collection (IC) Details

View Information Collection (IC)

42 CFR 50.606(c) or 45 CFR 94.6(c) (Disclosure)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 50.606(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Attach 2- Instructions (3) (3).docx No   Paper Only

Health Public Health Monitoring

 

50 0
   
Individuals or Households
 
   0 %

  Approved 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 150 0 0 0 0 150
Annual IC Time Burden (Hours) 45 0 0 0 0 45
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.