DELTA FOCUS PMIS: Semi-annual reporting

Monitoring and Reporting System for DELTA FOCUS Awardees

Documents and Forms

Document Name Document Type
DELTA FOCUS PMIS: Semi-annual reporting Form
DELTA FOCUS PMIS Att D_Instrument-PMIS Data Elements -ICRO.pdf Form

Information Collection (IC) Details

IC Title:	DELTA FOCUS PMIS: Semi-annual reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	DELTA FOCUS PMIS	Att D_Instrument-PMIS Data Elements -ICRO.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	60	60
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.