Information Collection

Tribal MIECHV Data System Planning

IC 219984 under ICR 201502-0970-004 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Tribal MIECHV Data System Planning Survey_2.2.16.docx	Other-Survey
Tribal MIECHV fast-track-PRA-submission-short-form_02-02-16.doc Tribal MIECHV Fast Track PRA Submission Short Form	IC Document

IC Title:

Tribal MIECHV Data System Planning

Agency IC Tracking Number:

OPRE - 07

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Tribal MIECHV Data System Planning Survey_2.2.16.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Tribal MIECHV Fast Track PRA Submission Short Form	Tribal MIECHV fast-track-PRA-submission-short-form_02-02-16.doc	02/04/2016

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