Application Cover Letter (initial and reconciliation)

Children's Hospital Graduate Medical Education Program

Documents and Forms

Document Name Document Type
Application Cover Letter (Initial and Recon) - Document.docx Other-not provided by grantee
Application Cover Letter (Initial and Recon) - Document.docx Other-not provided by grantee

Information Collection (IC) Details

IC Title:	Application Cover Letter (initial and reconciliation)	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-not provided by grantee			Application Cover Letter (Initial and Recon) - Document.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	120	60	60
Annual IC Time Burden (Hours)	40	20	20
Annual IC Cost Burden (Dollars)	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.