OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Initial Results Information Submission

IC 239358 under ICR 202512-0925-004 · OMB 0925-0586.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Initial Results Information Submission
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Results Information Submission Data Entry Forms Attachment 5 - Results Information PRS Data Entry Forms 2_11_2026.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

7,400 0
   
Private Sector Not-for-profit institutions
 
   100 %

  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 7,400 0 0 0 0 7,400
Annual IC Time Burden (Hours) 296,000 0 0 0 0 296,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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