Information Collection

UGSP - Contract

IC 265506 under ICR 202503-0925-001 · OMB 0925-0299.

Documents and Forms

Document Name Document Type
Form 1 UGSP - Contract Form
1 Survey A05-UGSP-Interview-Experience.pdf Form
1 Survey A05-UGSP-Interview-Experience.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	UGSP - Contract	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Survey	A05-UGSP-Interview-Experience.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	4	4
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.