OMB
.report
Search
Designation of Non Metro Area MUP/HPSA
Designation of Medically Underserved Populations and Health Professional Shortage Areas
OMB: 0915-0317
IC ID: 183982
OMB.report
HHS/HSA
OMB 0915-0317
ICR 200802-0915-002
IC 183982
( )
Documents and Forms
Document Name
Document Type
proposed method.doc
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Designation of Non Metro Area MUP/HPSA
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
42 CFR 5
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
proposed method.doc
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
54
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
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
909
909
0
0
0
0
Annual IC Time Burden (Hours)
9,908
9,908
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.