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

View Information Collection (IC)

Recipient-Led Evaluation Annual Report Template
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Yes Yes Fillable Fileable
Form and Instruction n/a Yes Yes Fillable Fileable
Form and Instruction n/a Yes Yes Fillable Fileable

Health Public Health Monitoring

 

51 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 51 0 0 0 0 51
Annual IC Time Burden (Hours) 408 0 0 0 0 408
Annual IC Cost Burden (Dollars) 14,688 0 0 0 0 14,688

Title Document Date Uploaded
Year 1 Implementation Brief 05/05/2020
Year 2 Efficiency Improvement Plan and Process Model 05/05/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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