OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Registrations and Recertifications for Entities other than Hospitals

IC 190347 under ICR 202208-0915-001 · OMB 0915-0327.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 2.1
Registrations and Recertifications for Entities other than Hospitals		 Form and Instruction
Form 2.1
340B Registration CHC and FQHCLA.pdf Registrations and Recertifications for Entities other than Hospitals		 Form and Instruction
Form 2.2
340B Registration STD and TB.pdf Registrations and Recertifications for Entities other than Hospitals		 Form and Instruction
Form 2.3
340B Registration-Covered Entities All Other Non-Hospitals.pdf Registrations and Recertifications for Entities other than Hospitals		 Form and Instruction
Form 2.4
340B Recertfication STD and TB.pdf Registrations and Recertifications for Entities other than Hospitals		 Form
Form 2.5
340B Recertification CHC and FQHCLA.pdf Registrations and Recertifications for Entities other than Hospitals		 Form
Form 2.6
340B Recertification Covered Entities All Other Non-Hospital..pdf Registrations and Recertifications for Entities other than Hospitals		 Form
2.1 340B Registration CHC and FQHCLA.pdf
340B Registration-Community Health Center.pdf 		Form and Instruction
2.1 340B Registration CHC and FQHCLA.pdf
340B Registration-Community Health Center.pdf 		Form and Instruction
2.2 340B Registration STD and TB.pdf
340B Registration-STD.TB.pdf 		Form and Instruction
2.2 340B Registration STD and TB.pdf
340B Registration-STD.TB.pdf 		Form and Instruction
2.3 340B Registration-Covered Entities All Other Non-Hospita
340B Registration-Covered Entities All Other.pdf 		Form and Instruction
2.3 340B Registration-Covered Entities All Other Non-Hospita
340B Registration-Covered Entities All Other.pdf 		Form and Instruction
2.4 340B Recertfication STD and TB.pdf
340B Recertfication-STD.TB.pdf 		Form
2.4 340B Recertfication STD and TB.pdf
340B Recertfication-STD.TB.pdf 		Form
2.5 340B Recertification CHC and FQHCLA.pdf
340B Recertification-Community Health Center and Look alike.pdf 		Form
2.5 340B Recertification CHC and FQHCLA.pdf
340B Recertification-Community Health Center and Look alike.pdf 		Form
2.6 340B Recertification Covered Entities All Other Non-Hosp
340B Recertification-Covered Entities All Other.pdf 		Form
2.6 340B Recertification Covered Entities All Other Non-Hosp
340B Recertification-Covered Entities All Other.pdf 		Form

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 and Instruction 2.1 Yes Yes Fillable Fileable
Form and Instruction 2.2 Yes Yes Fillable Fileable
Form and Instruction 2.3 Yes Yes Fillable Fileable
Form 2.4 Yes Yes Fillable Fileable
Form 2.5 Yes Yes Fillable Fileable
Form 2.6 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 19,153 0 -298 0 0 19,451
Annual IC Time Burden (Hours) 6,070 0 -298 0 0 6,368
Annual IC Cost Burden (Dollars) 0 0 0 0 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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