Survey on Rural Community Wealth and Health Care Provision - community leaser respondents in full study

Rural Community Wealth and Health Care Provision Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0536-0072 can be found here:

Documents and Forms

Document Name Document Type
Annex G_Community leaders questionnaire_7-12.docx Other-Community Leader questionnaie

Information Collection (IC) Details

IC Title:	Survey on Rural Community Wealth and Health Care Provision - community leaser respondents in full study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Community Leader questionnaie in full study			Annex G_Community leaders questionnaire_7-12.docx		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	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	0	0	0	0	0	0
Annual IC Time Burden (Hours)	0	0	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.