Refugee Health Promotion Data Indicators

Generic Performance Progress Report

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0490 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Refugee Health Promotion Data Indicators Form
RHP Data Indicator Form User Guide.docx Instruction
1 RHP Program Data Indicators Form RHP Program Data Indicators Form.docx Form
RHP_Template for PPR Gen IC.doc Justification IC Document

Information Collection (IC) Details

IC Title:	Refugee Health Promotion Data Indicators	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	RHP Program Data Indicators Form	RHP Program Data Indicators Form.docx		Yes	Yes	Fillable Printable
Instruction			RHP Data Indicator Form User Guide.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 41	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	41	41
Annual IC Time Burden (Hours)	123	123
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	RHP_Template for PPR Gen IC.doc	11/22/2017

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