State/Local/Tribal Sector-Initial population

Monitoring and Reporting System for the Division of Community Health's Cooperative Agreement Programs

OMB: 0920-1053

IC ID: 214565

Information Collection (IC) Details

View Information Collection (IC)

State/Local/Tribal Sector-Initial population
 
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 none DCH screenshots Att3a_DCH-PMD Screen Shots_3 14 16.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

14 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 14 0 0 0 0 14
Annual IC Time Burden (Hours) 210 0 0 0 0 210
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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