Information Collection

Appendix_C_RUDI_Provider_Subrecipient_Discussion_Guide

IC 263055 under ICR 202310-0906-001 · OMB 0906-0079.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Appendix_C_RUDI_Provider_Subrecipient_Discussion_Guide	Form and Instruction
2 Virtual site visit interviews Appendix_C_RUDI_Provider_Subrecipient_Discussion_Guide.docx	Form and Instruction
2 Virtual site visit interviews Appendix_C_RUDI_Provider_Subrecipient_Discussion_Guide.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
Form and Instruction	2	Virtual site visit interviews	Appendix_C_RUDI_Provider_Subrecipient_Discussion_Guide.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

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	120	120
Annual IC Time Burden (Hours)	120	120
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.