Information Collection

BUILD Institutional Research & Program Data Requests

IC 239808 under ICR 202305-0925-003 · OMB 0925-0747.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 BUILD Institutional Research & Program Data Requests	Form and Instruction
3 Data Request Form Attachment 13_BUILD Institutional Records and Program Data Requests.pdf	Form and Instruction
3 Data Request Form Attachment 13_BUILD Institutional Records and Program Data Requests.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	3	Data Request Form	Attachment 13_BUILD Institutional Records and Program Data Requests.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

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	Previously Approved
Annual Number of Responses for this IC	30	-14,970	15,000
Annual IC Time Burden (Hours)	480	-10,770	11,250
Annual IC Cost Burden (Dollars)	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.