State/Local/Tribal Sector - Special Data Reporting

Monitoring and Reporting System for the Division of Community Health's Cooperative Agreement Programs

OMB: 0920-1053

IC ID: 214567

Information Collection (IC) Details

View Information Collection (IC)

State/Local/Tribal Sector - Special Data Reporting
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Special Data Request Att 4_Special Data Request.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

41 0
   
State, Local, and Tribal Governments
 
   50 %

  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 41 0 41 0 0 0
Annual IC Time Burden (Hours) 246 0 246 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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