Partner Program Manager - Cost Resource and Utilization Tool

Paul Coverdell National Acute Stroke Program (2015-2020) Assessment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1233 can be found here:

Documents and Forms

Document Name Document Type
Partner Program Manager - Cost Resource and Utilization Tool Form and Instruction
Cost Resource and Utilization Tool A2. Screenshots of Partner Cost Collection Tool_1.5.2018.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Partner Program Manager - Cost Resource and Utilization Tool	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	NA	Cost Resource and Utilization Tool	A2. Screenshots of Partner Cost Collection Tool_1.5.2018.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 137	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	137	137
Annual IC Time Burden (Hours)	274	274
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.