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DIR Objective Review Assessment Survey
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Yes Yes Fillable Fileable
Form 1 Yes Yes Fillable Fileable
Form 1.2 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable
Other-Public Burden Screenshot Yes Yes Fillable Fileable

Health Health Care Services

 

2,300 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 2,300 0 0 0 0 2,300
Annual IC Time Burden (Hours) 575 0 0 0 0 575
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A - DIR Review Assessment Survey 06/04/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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