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OMB Control No: 0906-0084	ICR Reference No: 202608-0906-005
Status: Received in OIRA	Previous ICR Reference No: 202503-0906-002
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 08/27/2026

	Requested	Previously Approved
Expiration Date	02/28/2027	02/28/2027
Responses	136,977	136,977
Time Burden (Hours)	17,545	15,045
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	136,977	136,977	0
Annual Time Burden (Hours)	17,545	15,045	2,500
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 current allocation of burden hours for the Umbrella ICR is running low, due to the addition of higher burden hour collections (i.e., collections with above average number of respondents) as well as some previous duplicate collections. Assuming another 5 ICs being submitted this year, HRSA is requesting an additional 2500 burden hours with no increase in the number of burden responses.

Annual Cost to Federal Government: $249,390

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Laura Cooper 301 443-2126 lcooper@hrsa.gov

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