Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program

Reconciliation Tool for the Teaching Health Center Graduate Medical Education (THCGME) Program

Documents and Forms

Document Name Document Type
Instructions for THCGME Reconciliation Tool.docx Instruction
Instructions for THCGME Reconciliation Tool.docx Instruction
1 THCGME Reconciliation Tool Form THCGME Reconciliation Tool Form.docx Form
1 THCGME Reconciliation Tool Form THCGME Reconciliation Tool Form.docx Form

Information Collection (IC) Details

IC Title:	Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Instructions for THCGME Reconciliation Tool.docx		Yes	Yes	Fillable Fileable
Form	1	THCGME Reconciliation Tool Form	THCGME Reconciliation Tool Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 83	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	83	25	58
Annual IC Time Burden (Hours)	166	50	116
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.