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TCH Registration Form
OS Think Cultural Health
OMB: 0990-0407
IC ID: 219104
OMB.report
HHS/HHSDM
OMB 0990-0407
ICR 202208-0990-001
IC 219104
( )
Documents and Forms
Document Name
Document Type
Appendix B - TCH User Registration Form (12.2.15).pdf
Other-form
Appendix B - TCH User Registration Form (12.2.15).pdf
Other-form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
TCH Registration Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-form
Appendix B - TCH User Registration Form (12.2.15).pdf
Yes
Yes
Fillable Fileable
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:
9,460
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
9,460
0
0
0
9,460
0
Annual IC Time Burden (Hours)
473
0
0
0
473
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.
