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Federal forms, ICRs, and supporting documents

Information Collection

Supplemental Information Request for the Submission of the Updated State Plan for A State Home Visiting Program

IC 196112 under ICR 201107-0915-002 · OMB 0915-0336.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Supplemental Information Request for the Submission of the Updated State Plan for A State Home Visiting Program
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 SIR HRSA_Home_Visiting_2nd SIR FINAL 2011.docx Yes Yes Fillable Fileable

Health Health Care Services

 

56 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 56 0 0 0 0 56
Annual IC Time Burden (Hours) 15,176 0 0 0 0 15,176
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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