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ANE Program Specific Form
The Advanced Nursing Education (ANE) Program Specific Form
OMB: 0915-0375
IC ID: 209293
OMB.report
HHS/HSA
OMB 0915-0375
ICR 202403-0915-002
IC 209293
( )
Documents and Forms
Document Name
Document Type
Form 1
ANE Program Specific Form
Form and Instruction
1 ANE Program Specific Data Forms.docx
ANE Program Specific Data Form - Final Draft 03052024.docx
Form and Instruction
1 ANE Program Specific Data Forms.docx
ANE Program Specific Data Form - Final Draft 03052024.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ANE Program Specific Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Form and Instruction
1
ANE Program Specific Data Forms.docx
ANE Program Specific Data Form - Final Draft 03052024.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:
348
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, 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
348
0
-173
0
0
521
Annual IC Time Burden (Hours)
2,436
0
-1,211
0
0
3,647
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.