Information Collection

0917-0034, Sharing What Works - Best Practice, Promising Practice, and Local Efforts (BPPPLE)

IC 189459 under ICR 201512-0917-001 · OMB 0917-0034.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0917-0034 0917-0034, Sharing What Works - Best Practice, Promising Practice, and Local Efforts (BPPPLE)	Form and Instruction
0917-0034 IHS BPPPLE Form OMB_Form_No___IHS_BPPPLE_____ (2016) FINAL 9-28-2015 (004) tss rev and edits 11032015 - Accepted.docx www.ihs.gov/hpdp/bppple/	Form and Instruction
0917-0034 Supporting Statement FINAL 12-17-2015 TClay.doc 0917-0034, Supporting Statement for BPPPLE	IC Document
2015-25733.pdf 0917-0034, 60 Day Fed. Reg. Notice - Published	IC Document
OMB No 0917-0034 BPPPLE 60 Day FRN Final, 09-28-15.docx 0917-0034, 60 Day Fed. Reg. Notice (WORD)	IC Document
FR Publication 11-17-15 (002).pdf 0917-0034, 30 Day Fed. Reg. Notice - Published	IC Document
OMB No 0917-0034 BPPPLE 30 Day FRN Final 10-28-15 tss rev 11032015.docx 0917-0034, 30 Day Fed. Reg. Notice (WORD)	IC Document
2015-31534 Correction Notice 12-15-2015.pdf 0917-0034, Correction Notice (Published 12-15-15)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: Modified

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
Form and Instruction	0917-0034	IHS BPPPLE Form	OMB_Form_No___IHS_BPPPLE_____ (2016) FINAL 9-28-2015 (004) tss rev and edits 11032015 - Accepted.docx	https://www.ihs.gov/hpdp/bppple/	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0917-0034, Supporting Statement for BPPPLE	0917-0034 Supporting Statement FINAL 12-17-2015 TClay.doc	12/21/2015
0917-0034, 60 Day Fed. Reg. Notice - Published	2015-25733.pdf	12/21/2015
0917-0034, 60 Day Fed. Reg. Notice (WORD)	OMB No 0917-0034 BPPPLE 60 Day FRN Final, 09-28-15.docx	12/21/2015
0917-0034, 30 Day Fed. Reg. Notice - Published	FR Publication 11-17-15 (002).pdf	12/21/2015
0917-0034, 30 Day Fed. Reg. Notice (WORD)	OMB No 0917-0034 BPPPLE 30 Day FRN Final 10-28-15 tss rev 11032015.docx	12/21/2015
0917-0034, Correction Notice (Published 12-15-15)	2015-31534 Correction Notice 12-15-2015.pdf	12/21/2015

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