Information Collection

The AIM Biannual Survey Report

IC 267119 under ICR 202404-0915-003 · OMB 0915-0397.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 The AIM Biannual Survey Report	Form and Instruction
Form 1 AIM Biannual Report The AIM Biannual Survey Report	Form and Instruction
1 AIM Biannual Report REVISED-Attachment A-AIM Biannual Report-Proposed Final-Clean.docx	Form and Instruction
1 AIM Biannual Report REVISED-Attachment A-AIM Biannual Report-Proposed Final-Clean.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	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	104	104
Annual IC Time Burden (Hours)	104	104
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.

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