OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Frame Development for the National Survey of Long-Term Providers

ICR 201112-0920-008 · OMB 0920-0912 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
NSLTCP Frame Supp State Part B 11-23.doc Supporting Statement B Uploaded 2011-12-08 Available
Attachment F-Thank You Letter 8-19.doc Supplementary Document Uploaded 2011-12-09 Repair queued
Attachment A-NCHS Legislation 8-19.doc Supplementary Document Uploaded 2011-12-08 Available
Attachment C-Human Subjects 8-19.doc Supplementary Document Uploaded 2011-12-09 Available
Attachment D 4-Advance Package NCHS Confidentiality Brochure.doc Supplementary Document Uploaded 2011-12-09 Available
Attachment D 3-Advance Package Prof Assoc Letter.doc Supplementary Document Uploaded 2011-12-09 Available
Attachment D 2-Advance Package NCHS Cover Letter.doc Supplementary Document Uploaded 2011-12-09 Available
NSLTCP Frame Supp State Part A.doc Supporting Statement A Uploaded 2011-12-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
200463 Electronic File Development Instruction New
200462 Telephone Protocol Instruction New
200461 Contact Information Verification Instruction New
ICR Details
0920-0912 201112-0920-008
Historical Active
HHS/CDC
Frame Development for the National Survey of Long-Term Providers
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/12/2012
Retrieve Notice of Action (NOA) 12/13/2011
  Inventory as of this Action Requested Previously Approved
01/31/2013 12 Months From Approved
153 0 0
132 0 0
0 0 0
NCHS seeks approval to collect data needed to develop an up-to-date sampling frame of residential care facilities. The frame will be used to draw a nationally representative sample for a planned survey, the National Survey of Long- Term Care Providers.
US Code: 42 USC 242 Name of Law: USC
  
None
Not associated with rulemaking
  76 FR 34996 06/15/2011
76 FR 76413 12/07/2011
No
3
IC Title Form No. Form Name
Contact Information Verification
Telephone Protocol
Electronic File Development
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 153 0 0 153 0 0
Annual Time Burden (Hours) 132 0 0 132 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new information collection request.
$429,816
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Catina Conner 4046394775
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/13/2011