Grantee Data Collection Form

Frontier Community Healthcare Network Coordination Grant

OMB: 0915-0383

IC ID: 209805

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Grantee Data Collection Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 8 Grantee Data Collection Form GranteeDataCollection_OMBClearancePackage_10032013.docx Yes Yes Fillable Fileable

Health Health Care Services

 

11 0
   
Individuals or Households
 
   100 %

  Requested 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 44 0 44 0 0 0
Annual IC Time Burden (Hours) 176 0 176 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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