Information Collection

1999 Long-Term Care Survey

IC 3504 under ICR 199804-0607-001 · OMB 0607-0778.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0778 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	1999 Long-Term Care Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	LTC-3	Yes	Yes
Form	LTC-1	Yes	Yes
Form	LTC-9(L1)	Yes	Yes
Form	LTC-4	Yes	Yes
Form	LTC-9P(L1)	Yes	Yes
Form	LTC-9(L2)	Yes	Yes
Form	LTC-7	Yes	Yes
Form	BNL-1	Yes	Yes
Form	LTC-2	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 19,785	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	28,340	28,340
Annual IC Time Burden (Hours)	10,131	10,131
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.