Protection and Advocacy for Assistive Individuals with Traumatic Brain Injury (PATBI) Program Performance Report

Protection and Advocacy for Traumatic Brain Injury (PATBI) Program Performance Report

Documents and Forms

Document Name Document Type
Form 1 Protection and Advocacy for Assistive Individuals with Traumatic Brain Injury (PATBI) Program Performance Report Form and Instruction
1 PATBI Program Performance Report PATBI-PPR-Template with Burden Statement.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Protection and Advocacy for Assistive Individuals with Traumatic Brain Injury (PATBI) Program Performance Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	1	PATBI Program Performance Report	PATBI-PPR-Template with Burden Statement.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	912	912
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.