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Information Collection

57.141 Monthly Reporting Plan for LTCF

IC 200378 under ICR 202603-0920-006 · OMB 0920-0666.

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Document Type
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Form
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57.141 Monthly Reporting Plan for LTCF 0920-0666
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CDC 57.141 Monthly Reporting Plan for LTCF 57.141 Monthly Reporting Plan for LTCF.docx Yes Yes Fillable Fileable

Health Health Care Services

 

546 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 6,552 0 0 0 0 6,552
Annual IC Time Burden (Hours) 546 0 0 0 0 546
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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