Information Collection

BHPr Performance Report

IC 6345 under ICR 201304-0915-001 · OMB 0915-0061.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0061 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 BHPr Performance Report	Form and Instruction
1 PRGCA Manual PRGCA_Manual Final 06082012.pdf	Form and Instruction
Programs Reporting _SS.docx Programs Reporting _SS	IC Document
Performance goals model.docx Performance goals model	IC Document

IC Title:

BHPr Performance Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	PRGCA Manual	PRGCA_Manual Final 06082012.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,300	2,300
Annual IC Time Burden (Hours)	-13,600	13,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Programs Reporting _SS	Programs Reporting _SS.docx	06/13/2012
Performance goals model	Performance goals model.docx	06/13/2012

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