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Federal forms, ICRs, and supporting documents

Information Collection

Less than 500 Affected Individuals (investigating and documenting breach)

IC 221883 under ICR 202509-0945-001 · OMB 0945-0003.

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Information Collection (IC) Details

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Less than 500 Affected Individuals (investigating and documenting breach)
 
No Unchanged
 
Mandatory
 
45 CFR Parts 160 and 164  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

2,324 0
   
State, Local, and Tribal Governments
 
   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 2,324 0 0 0 0 2,324
Annual IC Time Burden (Hours) 18,592 0 0 0 0 18,592
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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