View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Needs Assessment for Developing a Network of LEHPs 16AGD
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Yes Yes Fillable Fileable
Other-Screenshots Yes Yes Paper Only

Health Illness Prevention

 

500 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 500 0 500 0 0 0
Annual IC Time Burden (Hours) 125 0 125 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att A _Local Health Department Listin 04/27/2016
Att B__ Authorizing Law 04/27/2016
Att C_Madison County LHD Exampl 04/27/2016
Att F_EHCA Notification Email 04/27/2016
Att G _EHCA Reminder Email 04/27/2016
EHCA-SSA 04/27/2016
EHCA-SSB 04/27/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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