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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.