View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Geriatrics Extended Care (GEC) Survey	Agency IC Tracking Number:	2900-0876-GEC

IC Status: New

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	2900-0876-GEC-survey wireframes	2900-0876-GEC-survey wireframes	GEC_SurveyEmail_v9.pdf_FINAL.pdf		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: 16,796	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	16,796	0	16,796	0	0	0
Annual IC Time Burden (Hours)	1,400	0	1,400	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
A-11 Fast-Track Clearance Request Template_GEC	A-11 Fast-Track Clearance Request Template_GEC.pdf	06/15/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.