View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0985-0040	ICR Reference No: 201606-0985-003
Status: Historical Active	Previous ICR Reference No: 201503-0985-001
Agency/Subagency: HHS/ACL	Agency Tracking No: 18891
Title: State Health Insurance Assistance Program (SHIP) Client Contact Form, Pubic and Media Activity Form, and Resource Report Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/24/2017
	Date Received in OIRA: 06/30/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	36 Months From Approved	03/31/2017
Responses	3,700,038	0	2,346,465
Time Burden (Hours)	326,872	0	195,642
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	3,700,038	2,346,465	1,353,573
Annual Time Burden (Hours)	326,872	195,642	131,230
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The reporting for this collection went from semi annually to quarterly which caused an increase in burden hours.

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