Information Collection

FIC Grantee Network Meetings

IC 268230 under ICR 202210-0925-007 · OMB 0925-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Registration FIC Grantee Network Meetings	Form
1 Registration FIC Network Meeting Screenshots.docx	Form
Sub-Study 2.0 - FIC Network Mtg.docx Template	IC Document
FIC Network Meeting Registration Emails.docx Email Correspondence	IC Document

IC Title:

FIC Grantee Network Meetings

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: HHS Correspondence, Comment, Customer Service, and Contact List Records

FR Citation: 86 FR 12699

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,000	1,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template		06/14/2024
Email Correspondence		06/14/2024

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

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