Information Collection

Uniform Data System

IC 6420 under ICR 202403-0915-003 · OMB 0915-0193.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0193 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Uniform Data System Form and Instruction
1 UDS Tables Excel Format OMB 0193_UDS Tables Excel Format.xlsx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Uniform Data System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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	1	UDS Tables Excel Format	OMB 0193_UDS Tables Excel Format.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,978	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,978	1,978
Annual IC Time Burden (Hours)	375,324	375,324
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.