View Information Collection (IC)

View Information Collection (IC)

IC Title:	National Implementation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Cover Letter			OAS CAHPS_OMB_Attachment_B_Cover Letter_rev 10-2015 [rev 10-28-2015 by OSORA PRA].docx		No		Paper Only
Other-Cover Letter Crosswalk			OAS CAHPS_OMB_Crosswalk_Cover_Letter_10-27-15 [rev 10-28-2015 by OSORA PRA].docx		No		Paper Only

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: 2,808,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	2,808,900	0	0	0	0	2,808,900
Annual IC Time Burden (Hours)	365,157	0	0	0	0	365,157
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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