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Federal forms, ICRs, and supporting documents

Information Collection

A listing of all respondents

IC 191465 under ICR 202306-0938-012 · OMB 0938-1078.

Documents and Forms
Document Name
Document Type
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Information Collection (IC) Details

View Information Collection (IC)

A listing of all respondents
 
No Unchanged
 
Mandatory
 
42 CFR 414.930

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

845 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 100 0 0 0 0 100
Annual IC Time Burden (Hours) 845 0 0 0 0 845
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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