Office of State and National Partnership's Web-based Semi Annual Report

ICR 200310-0915-003

OMB: 0915-0262

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0915-0262 200310-0915-003
Historical Active 200204-0915-001
HHS/HSA
Office of State and National Partnership's Web-based Semi Annual Report
Revision of a currently approved collection   No
Regular
Approved without change 12/08/2003
Retrieve Notice of Action (NOA) 10/23/2003
  Inventory as of this Action Requested Previously Approved
12/31/2006 12/31/2006 06/30/2005
212 0 212
3,816 0 3,816
0 0 0

SAR will collect annual reporting requirements for the primary care grantees of specific outcomes/results of their activities and services utilized by and provided to those targeted populations and areas identified and other activities that fall within the scope of the grant.

None
None


No

1
IC Title Form No. Form Name
Office of State and National Partnership's Web-based Semi Annual Report

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 212 212 0 0 0 0
Annual Time Burden (Hours) 3,816 3,816 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/23/2003


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