Information Collection

Parent Program Manager TA Tracking Form

IC 206024 under ICR 201512-0920-010 · OMB 0920-0941.

Documents and Forms

Document Name Document Type
Parent Program Manager TA Tracking Form Form
Parent Program Manager (PPM) Technical Assistance Tracki Atmt LLLL - Parent_Program_Manager_TA_Tracking_ Form.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Parent Program Manager TA Tracking Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Parent Program Manager (PPM) Technical Assistance Tracking form	Atmt LLLL - Parent_Program_Manager_TA_Tracking_ Form.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-200	200
Annual IC Time Burden (Hours)	-33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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