OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Process Evaluation and Special Studies Related to the Long-Term Care OMBudsman Program

OMB 0985-0055 · HHS/ACL.

OMB 0985-0055

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 Volunteers Survey Form
Form 1 Local Directors/Regional Representaitves and Local Representatives Form
Form 1 State Ombudsman Interview Protocol and Survey Form
Form 1 National Stakeholders Interview Protocol Form
Form 1 Federal Staff National Stakeholders Form
Nonsubstantive Changes for Phase 2 of LTCOP Data Collection (0985-0055) (11-27-17).docx Justification for No Material/Nonsubstantive Change
OMB Package Section B_FINAL.docx Supporting Statement B
OMB Package Section A-FINAL-REVISED.docx Supporting Statement A
Volunteers Survey Form
Local Directors/Regional Representaitves and Local Representatives Form
State Ombudsman Interview Protocol and Survey Form
National Stakeholders Interview Protocol Form
Federal Staff National Stakeholders Form

All Historical Document Collections

201712-0985-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-12-01
201612-0985-003 Approved without change	New collection (Request for a new OMB Control Number)	2016-12-23