Nomination Form

Million Hearts Hypertension Control Challenge

OMB: 0920-0976

IC ID: 206920

Information Collection (IC) Details

View Information Collection (IC)

Nomination Form
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Nomination Form Attachment 3a Nomination Form_7 23 2013.docm Yes Yes Fillable Fileable
Form none Website Screenshots Attachment 6 Screenshots 7-24-2013.pdf Yes Yes Fillable Fileable

Health Immunization Management

 

1,735 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 1,735 0 0 0 0 1,735
Annual IC Time Burden (Hours) 868 0 0 0 0 868
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Confirmation Email Attachment 3b. Confirmation email_4 4 2013.docx 05/08/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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