Information Collection

Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program

IC 197986 under ICR 202509-0915-002 · OMB 0915-0342.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 THCGME Reconciliation Tool Form Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program	Form
Instructions for THCGME Reconciliation Tool 0915-0342.docx	Instruction
Instructions for THCGME Reconciliation Tool 0915-0342.docx	Instruction
1 THCGME Reconciliation Tool Form THCGME Reconciliation Tool Form 0915-0342.docx	Form
1 THCGME Reconciliation Tool Form THCGME Reconciliation Tool Form 0915-0342.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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
Instruction					Yes	Yes	Fillable Fileable
Form	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 87

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	87	4	83
Annual IC Time Burden (Hours)	435	269	166
Annual IC Cost Burden (Dollars)	0	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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