Supplemental Baseline Questions (grantees)

Health Profession Opportunity Grants (HPOG) program

OMB: 0970-0394

IC ID: 202865

Documents and Forms
Document Name
Document Type
Other-Supplementatal Baseline Data
Information Collection (IC) Details

View Information Collection (IC)

Supplemental Baseline Questions (grantees)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Supplementatal Baseline Data Instrument 1_Supplemental Baseline Data 10-17-12 v2 doc.doc Yes Yes Fillable Fileable

Community and Social Services Social Services

 

20 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 5,125 0 5,125 0 0 0
Annual IC Time Burden (Hours) 1,281 0 1,281 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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