Information Collection Request
OMHA Annual Appellant Climate Survey
ICR 202403-0990-005 · OMB 0990-0330 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form Appendix B1 Health Care Providers and Suppliers |
Form and Instruction | Modified | Missing upstream |
 Appellant Climate Survey OMB Part A - Final.docx |
Supporting Statement A | Uploaded 2024-04-17 | Available |
 60-day FRN 0990-0330.pdf |
Supplementary Document | Uploaded 2024-03-20 | Missing upstream |
| Appellant Climate Survey OMB Part B - Revised4 Final.docx |
Supporting Statement B | Uploaded 2024-03-20 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 184626 |  Beneficiaries |
Other-Introductory Letter English | Modified | |
| 184625 | Health Care Providers and Suppliers |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/HHSDM |
| OMB Control No | 0990-0330 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202103-0990-004 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |