Information Collection

Delinquent Audit Follow-up Email and Attestation

IC 264091 under ICR 202505-0906-003 · OMB 0906-0083.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Delinquent Audit Follow-up Email and Attestation	Form and Instruction
Form 2 Delinquent Audit Follow-Up Attestation Form. Delinquent Audit Follow-up Email and Attestation	Form and Instruction
Delinquent Audit Follow-Up Targeted Email_Final.docx	Instruction
Delinquent Audit Follow-Up Targeted Email_Final.docx	Instruction
2 Delinquent Audit Follow-Up Attestation Form. Delinquent Audit Follow-Up Attestation Form_Final.docx	Form and Instruction
2 Delinquent Audit Follow-Up Attestation Form. Delinquent Audit Follow-Up Attestation Form_Final.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	2				Yes	Yes	Fillable Fileable
Instruction					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	42,000	42,000
Annual IC Time Burden (Hours)	10,500	10,500
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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