BHPr Funding Strategy Evaluation - Applicants who did not receive funding

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form PCRE-1 BHPr Funding Strategy Evaluation - Applicants who did not receive funding Form
PCRE-1 PCRE Survey - Eligible, Applied but not funded Cohort 2 Applied Not Funded Interview Guide FINAL 05 24 2011.doc Form
PCRE Evaluation_Cohort 2_Supporting Statement.rtf Supporting Statement IC Document
Evaluation Interview One-pager.docx Evaluation Interview: Informational one-pager IC Document

Information Collection (IC) Details

IC Title:	BHPr Funding Strategy Evaluation - Applicants who did not receive funding	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PCRE-1	PCRE Survey - Eligible, Applied but not funded	Cohort 2 Applied Not Funded Interview Guide FINAL 05 24 2011.doc		No	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	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	50	0	0	0	0	0
Annual IC Time Burden (Hours)	25	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	PCRE Evaluation_Cohort 2_Supporting Statement.rtf	08/09/2011
Evaluation Interview: Informational one-pager	Evaluation Interview One-pager.docx	08/09/2011

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