Information Collection

IHS Urban Indian Health Program Common Reporting Requirements

IC 6565 under ICR 201108-0917-001 · OMB 0917-0007.

Documents and Forms

Document Name Document Type
Form 0917-0007 IHS Urban Indian Health Program Common Reporting Requirements Form and Instruction
0917-0007 UDS Reporting Instructions for OUIHP Programs 2010 UIHP Manual _2011Feb 17 2011 final.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	IHS Urban Indian Health Program Common Reporting Requirements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0917-0007	UDS Reporting Instructions for OUIHP Programs	2010 UIHP Manual _2011Feb 17 2011 final.doc		No	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 33	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 Agency Discretion
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	792	792
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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