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Tribal MIECHV Quarterly Performance Report
Tribal Maternal, Infant, and Early Childhood Home Visiting Program Data Reports: Demographic and Service Utilization, Grantee Performance Measures and Quarterly Performance Reports
OMB: 0970-0614
IC ID: 260666
OMB.report
HHS/ACF
OMB 0970-0614
ICR 202407-0970-011
IC 260666
( )
Documents and Forms
Document Name
Document Type
Form QPR
Tribal MIECHV Quarterly Performance Report
Form and Instruction
QPR Tribal MIECHV Quarterly Performance Report
THV QPR Form 2023_FINAL 04.10.2023.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Tribal MIECHV Quarterly Performance Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
QPR
Tribal MIECHV Quarterly Performance Report
THV QPR Form 2023_FINAL 04.10.2023.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
55
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
220
0
0
0
0
220
Annual IC Time Burden (Hours)
550
0
0
0
0
550
Annual IC Cost Burden (Dollars)
0
0
0
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.