View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0915-0293	ICR Reference No: 201108-0915-003
Status: Historical Active	Previous ICR Reference No: 200807-0915-004
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Free Clinics FTCA Program Application
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/12/2011
	Date Received in OIRA: 08/31/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved	12/31/2011
Responses	200	0	150
Time Burden (Hours)	2,800	0	2,400
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	200	150	50
Annual Time Burden (Hours)	2,800	2,400	400
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The number of hours per free clinic application has been reduced from 16 to 14 hours due to the electronification of the application. The number of respondents, however, has increased from 150 to 200. The current inventory of burden hours for this activity is 2,400 hours and this request is for 2,800 annual burden hours.

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