Information Collection

Part C Allocations Report

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

Documents and Forms

Documents and forms in this information collection
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

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
Form	C-1				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 %

table that charts list of burden
	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

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.

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