OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

WISEWOMAN Programs

IC 183886 under ICR 201103-0920-002 · OMB 0920-0679.

Documents and Forms
Document Name
Document Type
Other-WORD
Other-WORD
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

WISEWOMAN Programs
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD CHB MIS Data Collection Tool.doc No No Fillable Printable
Other-WORD Attachment 6. Proposed Revisions.doc No No Fillable Printable

Health Public Health Monitoring

 

15 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 0 0 -30 0 0 30
Annual IC Time Burden (Hours) 0 0 -180 0 0 180
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Usability Testing Results Attachment 5. Usability Results.doc 01/16/2008
Usability and Pilot Tests Participants Attachment 4. Usability Test Participants.doc 01/16/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.