Information Collection

Community Residential Care

IC 223586 under ICR 201403-2900-007 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Document Name Document Type
FINAL - CRC Cover and survey.docx Other-Survey
FINAL - CRC Clearance Submission Template.doc CRC Generic Request IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Community Residential Care	Agency IC Tracking Number:	2900-0770

IC Status: New

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-Survey			FINAL - CRC Cover and survey.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,200	3,200
Annual IC Time Burden (Hours)	267	267
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CRC Generic Request	FINAL - CRC Clearance Submission Template.doc	09/19/2016

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