Grantee - Quarterly Reports

Primary and Behavioral Health Care Integration Program

OMB: 0930-0340

IC ID: 196137

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Grantee - Quarterly Reports
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Quarterly Report Quarterly Report Attachment 2 Quarterly Report.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

70 0
   
State, Local, and Tribal Governments
 
   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 280 0 56 0 0 224
Annual IC Time Burden (Hours) 560 0 112 0 0 448
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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