OMB Number 0915-0061
Expiration date XX/XX/201X
Public
Burden Statement: An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The
OMB control number for this project is 0915-0061. Public
reporting burden for this collection of information is estimated to
average .25 hours per response, including the time for reviewing
instructions, searching existing data sources, and completing and
reviewing the collection of information. Send comments regarding
this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to
HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-29,
Rockville, Maryland, 20857.
TYPE OF RESPONDENT: Grantees of Infrastructure Programs
Grantees of Direct Financial Support Programs
Grantees of Multipurpose or Hybrid Programs
Objective A
Accomplishments
Objective B
Description of Objective
Accomplishments
Objective C
Description of Objective
Accomplishments
Barrier A
Description
Activities Taken to Resolve
Barrier B
Description
Activities Taken to Resolve
Please identify any technical assistance needs that will assist your organization in meeting project objectives and/or improve performance.
1 Note: grantees will have the ability to list up to 9 objectives and related accomplishments.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Supporting Statement |
Author | Namratha Swamy |
File Modified | 0000-00-00 |
File Created | 2021-01-29 |