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Mid-Year Report
Hospital Preparedness Program Data Collection
OMB: 0990-0326
IC ID: 184073
OMB.report
HHS/HHSDM
OMB 0990-0326
ICR 200909-0990-003
IC 184073
( )
Documents and Forms
Document Name
Document Type
0990-Hospital Preparedness ProgramCopy of 12_18 Cooperative Agreement Tool OMB Version.xls
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Mid-Year Report
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
Instruction
0990-Hospital Preparedness ProgramCopy of 12_18 Cooperative Agreement Tool OMB Version.xls
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Disaster Preparedness and Planning
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
62
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
62
0
0
0
0
62
Annual IC Time Burden (Hours)
992
0
0
0
0
992
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.
