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Information Collection

Unanticipated Problem or Serious or Continuing Noncompliance Application (Attachment B52)

IC 265724 under ICR 202411-0925-001 · OMB 0925-0753.

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Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

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Unanticipated Problem or Serious or Continuing Noncompliance Application (Attachment B52)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Unanticipated Problem or Serious or Continuing Noncompliance Application Attachment B52_Unanticipated_Problem_Noncompliance_Application_01AUG2023.docx Yes Yes Fillable Fileable

Health Health Care Services

 

20 0
   
Individuals or Households
 
   0 %

  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 20 0 0 0 0 20
Annual IC Time Burden (Hours) 10 0 0 0 0 10
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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