P4C Supplemental Funding Progress Report

Partnerships for Care (P4C) Progress Reports

OMB: 0906-0011

IC ID: 216661

Documents and Forms
Information Collection (IC) Details

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P4C Supplemental Funding Progress Report
 
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Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 P4C Implementation Form P4C Implementation Form.docx Yes Yes Fillable Fileable
Form and Instruction 2 P4C Outcomes Form P4C Outcomes Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

44 0
   
Private Sector Not-for-profit institutions
 
   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 44 0 44 0 0 0
Annual IC Time Burden (Hours) 660 0 660 0 0 0
Annual IC Cost Burden (Dollars) 7,333 0 7,333 0 0 0

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