Web-Based Data Collection Tool Question Pool

Maternal Health Portfolio Evaluation

OMB: 0906-0059

IC ID: 244129

Information Collection (IC) Details

View Information Collection (IC)

Web-Based Data Collection Tool Question Pool
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Attachment B3_Web-Based Data Collection Tool-Cross-Cutting_2023.docx Yes Yes Fillable Fileable

Health Health Care Services

 

12 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 12 0 -3 0 0 15
Annual IC Time Burden (Hours) 6 0 -2 0 0 8
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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