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Federal forms, ICRs, and supporting documents

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2018/2019 PMHCA/2018 MDRBD Care Coordinator SSI

IC 256686 under ICR 202302-0906-003 · OMB 0906-0074.

Documents and Forms
Document Name
Document Type
Other-Semi Structured Interview
Other-Semi Structured Interview
Information Collection (IC) Details

View Information Collection (IC)

2018/2019 PMHCA/2018 MDRBD Care Coordinator SSI
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Semi Structured Interview Attachment B12 - MDRBD Care Coordinator SSI - Copy.docx Yes Yes Fillable Fileable

Health Health Care Services

 

28 28
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 28 0 0 0 0 28
Annual IC Time Burden (Hours) 14 0 0 0 0 14
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.