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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
MCH Jurisdictional Survey Instrument for the Title V MCH Block Grant Program
Modified
7303
2002
0
Form and Instruction
1
questionnaire PR english.docx
Form and Instruction
1 B
questionnaire PR spanish.docx
Form and Instruction
2
questionnaire USVI english.docx
Form and Instruction
2 B
questionnaire USVI spanish.docx
Form and Instruction
3
questionnaire Guam english.docx
Form and Instruction
3 B
questionnaire Guam chuukese.docx
Form and Instruction
3 C
questionnaire Guam tagalog.docx
Form and Instruction
4
questionnaire AS english.docx
Form and Instruction
4 B
questionnaire AS samoan.docx
Form and Instruction
5
questionnaire FSM english.docx
Form and Instruction
5 B
questionnaire FSM chuukese.docx
Form and Instruction
5 C
questionnaire FSM pohnpeian.docx
Form and Instruction
6
questionnaire RMI english.docx
Form and Instruction
6 B
questionnaire RMI marshallese.docx
Form and Instruction
7
questionnaire CNMI english.docx
Form and Instruction
8
questionnaire Palau english.docx
Form and Instruction
8 B
questionnaire Palau palauan.docx
Form and Instruction
8 C
questionnaire Palau tagalog.docx
Total burden requested under this ICR:
7303
2002
0
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