View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Att 6c_MPINC Facility Survey 0920-0743
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD No   Paper Only
Form and Instruction 0920-0743 Yes Yes Fillable Fileable

Health Health Care Services

 

1,421 0
   
Private Sector Businesses or other for-profits
 
   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 1,421 0 1,421 0 0 0
Annual IC Time Burden (Hours) 711 0 711 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 6a_Survey Cover Letter 08/14/2018
Att 6b_Survey Cover Letter (E-mail) 08/14/2018
Att 6d_Reminder 08/14/2018
Att 6e_Reminder (e-mail) 08/14/2018
Att 6f_Non-Responder Follow-Up 08/14/2018
Att 6g_Non-Responder Script 08/14/2018
Att 6h_Returned Surveys 08/14/2018
Att 6i_Returned Surveys (E-mail) 08/14/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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