BHPr Performance Measures Forms

BHPr Performance Report for Grants and Cooperative Agreements

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0061 can be found here:

Documents and Forms

Document Name Document Type
Form B BHPr Performance Measures Forms Form and Instruction
B Appendix B Progress Report AppendixBProgressReport.docx Form and Instruction
C Appendix C Performance Measures AppendixCPerformance Measures.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	BHPr Performance Measures Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	B	Appendix B Progress Report	AppendixBProgressReport.docx		Yes	Yes	Fillable Fileable
Form and Instruction	C	Appendix C Performance Measures	AppendixCPerformance Measures.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,500	-57	1,557
Annual IC Time Burden (Hours)	5,710	-282	5,992
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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