PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Data Submission
Modified
60
60
0
Form and Instruction
Form #4
NH Welcome and Login Pages
Data Use Agreement
Modified
60
3
0
Form and Instruction
Form #2
Data Use Agreement
Eligibility/Registration Form
Modified
60
3
0
Form and Instruction
Form #1
Eligibility/Registration Form
Nursing Home Site Information Form
Modified
300
25
0
Form
Form #3
Nursing Home Site Information Form
Total burden requested under this ICR:
480
91
0
To view an IC, click on IC Title
An official website of the United States government
The .gov means it's official.
The site is secure.
