Information Collection Request

Affordable Care Act Tribal Maternal, Infant, and Early Childhood Home Visiting Guidance

ICR 201804-0970-002 · OMB 0970-0409 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Tribal HV Annual Report Supporting Statement 2018 FINAL.doc Supporting Statement A Uploaded 2018-04-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231062 Guidance Instruction New
202863 Annual Report Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2021 36 Months From Approved 10/31/2018
25 0 25
1,250 0 1,250
0 0 0





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1
table that charts list of burden
IC Title Form No. Form Name
Annual Report
Guidance

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 25 25 0 25 -25 0
Annual Time Burden (Hours) 1,250 1,250 0 1,250 -1,250 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No