Information Collection

Caregivers to Consumers with I/DD

IC 260200 under ICR 202305-3041-001 · OMB 3041-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3041-0136 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Focus Group Package - Caregivers to Consumers with IDD.docx	Instruction

IC Title:

Caregivers to Consumers with I/DD

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
Instruction					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450

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	450	450
Annual IC Time Burden (Hours)	185	185
Annual IC Cost Burden (Dollars)	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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