Information Collection

HIT Workforce Program Performance Measures

IC 211871 under ICR 201406-0915-002 · OMB 0915-0389.

Documents and Forms

Document Name Document Type
Form 1 HIT Workforce Program Performance Measures Form
1 Performance Measures HRSA-13-251 PIMS Measures.doc Form
NP Legislation.pdf Legislation IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HIT Workforce Program Performance Measures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Performance Measures	HRSA-13-251 PIMS Measures.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 15

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Legislation	NP Legislation.pdf	06/12/2014

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