Collection of this information is required as a condition of access to Healthcare Cost and Utilization Project data
products. The information collection supports requirements of the Public Health Service Act (42 U.S.C. 299c-3(c)), and
is used for 1) completion of order transactions, and 2) for enforcement of the HCUP Data Use Agreement. As required by
the Privacy Act of 1974, any identifying information obtained will be kept private to the extent provided by law. Public
reporting burden for this collection of information is estimated to average 30 minutes per response, the estimated time
required to complete the application. An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ
Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0206) AHRQ, 5600 Fishers Lane, # 07W41A, Rockville, MD 20857.
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