Information Collection

Annual Program Performance Report

IC 7549 under ICR 201705-0930-004 · OMB 0930-0169.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0169 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Report Annual Program Performance Report	Form
Attachment 2 44030217 PAIMI PPR Instructions.docx	Instruction
Report Report Attachment 1 022317 PAIMI PPR on AIDD PPR.docx	Form
Attachment 4 PPR Cover letter for EDs.docx Cover letter for EDs	IC Document

IC Title:

Annual Program Performance Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	Report	Report	Attachment 1 022317 PAIMI PPR on AIDD PPR.docx		Yes	Yes	Fillable Fileable
Instruction			Attachment 2 44030217 PAIMI PPR Instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 57

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	1,482	1,482
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cover letter for EDs	Attachment 4 PPR Cover letter for EDs.docx	05/30/2017

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