Information Collection

PAIMI 42CFR Part51

IC 254646 under ICR 202206-0930-003 · OMB 0930-0172.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A - PAIMI_Rules_42CFR_Part51 - 10052021.docx PAIMI 42CFR Part51	IC Document
Attachment A - PAIMI_Rules_42CFR_Part51 - 10052021.docx PAIMI 42CFR Part51	IC Document

IC Title:

PAIMI 42CFR Part51

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 51

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

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: PAIMI 42CFR Part51

FR Citation: 75 FR 28264

Number of Respondents: 57

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	196	196
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PAIMI 42CFR Part51	Attachment A - PAIMI_Rules_42CFR_Part51 - 10052021.docx	07/14/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.