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Information Collection

FFS Site Visit Form (Form M-3A) - Respondents

IC 245575 under ICR 202403-0970-014 · OMB 0970-0564.

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

View Information Collection (IC)

FFS Site Visit Form (Form M-3A) - Respondents
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form M-3A FFS Compliance and Safety Site Visit Report FFS Site Visit Form_2024 03 22.pdf Yes Yes Fillable Fileable

Community and Social Services Social Services

 

262 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 3,144 0 0 0 0 3,144
Annual IC Time Burden (Hours) 3,144 0 0 0 0 3,144
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.