Information Collection

Appendix_D_RUDI_A_B_Admin_Recipient_Discussion_Guide

IC 263057 under ICR 202310-0906-001 · OMB 0906-0079.

Documents and Forms

Document Name Document Type
Form 4 Appendix_D_RUDI_A_B_Admin_Recipient_Discussion_Guide Form and Instruction
4 RWHAP Recipient Interviews (Large and Small Sites) Appendix_D_RUDI_A_B_Admin_Recipient_Discussion_Guide.docx Form and Instruction
4 RWHAP Recipient Interviews (Large and Small Sites) Appendix_D_RUDI_A_B_Admin_Recipient_Discussion_Guide.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Appendix_D_RUDI_A_B_Admin_Recipient_Discussion_Guide	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	RWHAP Recipient Interviews (Large and Small Sites)	Appendix_D_RUDI_A_B_Admin_Recipient_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: 45	Number of Respondents for Small Entity: 30

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	45	45
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	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.