Information Collection

Part C Allocations Report

IC 183275 under ICR 202603-0915-001 · OMB 0915-0318.

Documents and Forms

Document Name Document Type
Form C-1 Part C Allocations Report Part C Allocations Report Form
Form C-1 Part C Allocations Report Part C Allocations Report Form
C-1 Part C Allocations Report RWHAP Part C Allocations Report Form_FINAL.xlsx Form
C-1 Part C Allocations Report RWHAP Part C Allocations Report Form_FINAL.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Part C Allocations Report	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	C-1	Part C Allocations Report	RWHAP Part C Allocations Report Form_FINAL.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 346	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	346	0	346
Annual IC Time Burden (Hours)	1,038	-346	1,384
Annual IC Cost Burden (Dollars)	0	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].