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Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program
Reconciliation Tool for the Teaching Health Center Graduate Medical Education (THCGME) Program
OMB: 0915-0342
IC ID: 197986
OMB.report
HHS/HSA
OMB 0915-0342
ICR 202302-0915-005
IC 197986
( )
Documents and Forms
Document Name
Document Type
Instructions for THCGME Reconciliation Tool.docx
Instruction
Instructions for THCGME Reconciliation Tool.docx
Instruction
1 THCGME Reconciliation Tool Form
THCGME Reconciliation Tool Form.docx
Form
1 THCGME Reconciliation Tool Form
THCGME Reconciliation Tool Form.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Instructions for THCGME Reconciliation Tool.docx
Yes
Yes
Fillable Fileable
Form
1
THCGME Reconciliation Tool Form
THCGME Reconciliation Tool Form.docx
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:
83
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
83
0
25
0
0
58
Annual IC Time Burden (Hours)
166
0
50
0
0
116
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.