Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
The Health Center Program Application Forms Modified 800 400 0 Form 0285-12
The Health Center Program Application Forms Modified 900 450 0 Form 0285- Assurances
The Health Center Program Application Forms Modified 250 625 0 Form 0285-1a
The Health Center Program Application Forms Modified 1034 2068 0 Form 0285-1b
The Health Center Program Application Forms Modified 800 3200 0 Form 0285-HC Plan-SAC NAP
The Health Center Program Application Forms Modified 800 3200 0 Form 0285-Business Plan-SAC NAP
The Health Center Program Application Forms Modified 200 300 0 Form 0285-Relocate Site
The Health Center Program Application Forms Modified 100 100 0 Form 0285-Add Services
The Health Center Program Application Forms Modified 1034 2068 0 Form 0285-Business Plan-BPR
The Health Center Program Application Forms Modified 300 300 0 Form 0285-Add Site Checklist
The Health Center Program Application Forms Modified 200 200 0 Form 0285-Delete Site Checklist
The Health Center Program Application Forms Modified 100 100 0 Form 0285-Delete Services
The Health Center Program Application Forms Modified 1034 1034 0 Form 0285-4
The Health Center Program Application Forms Modified 1034 2068 0 Form 0285-2
The Health Center Program Application Forms Modified 1034 5170 0 Form 0285-3
The Health Center Program Application Forms Modified 1034 1034 0 Form 0285-4
The Health Center Program Application Forms Modified 1034 1034 0 Form 0285-5a
The Health Center Program Application Forms Modified 900 900 0 Form 0285-Equipment list
The Health Center Program Application Forms Modified 900 450 0 Form 0285-Other Reqs
The Health Center Program Application Forms Modified 1034 1034 0 Form 0285-5b
The Health Center Program Application Forms Modified 700 350 0 Form 0285-5c
The Health Center Program Application Forms Modified 1034 1034 0 Form 0285-6a
The Health Center Program Application Forms Modified 150 150 0 Form 0285-6b
The Health Center Program Application Forms Modified 1034 2068 0 Form 0285- HC Plan- BPR
The Health Center Program Application Forms Modified 250 250 0 Form 0285-8
The Health Center Program Application Forms Modified 900 2700 0 Instruction
Form 0285-9
The Health Center Program Application Forms Modified 1034 1034 0 Form 0285-10
The Health Center Program Application Forms Modified 700 700 0 Form 0285-Proposal Cover Pg
The Health Center Program Application Forms Modified 700 700 0 Form 0285-Project Cover
The Health Center Program Application Forms Modified 700 350 0 Form 0285-Project Impact
The Health Center Program Application Forms Modified 1034 2068 0 Form 0285-1a
Total burden requested under this ICR: 22758 37139 0  
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