Guidance

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0409 can be found here:

Documents and Forms

Document Name Document Type
2017-Tribal MIECHV Guidance for Submitting an Annual or Final Report to the Secretary FINAL FORMATTED.docx Instruction
Appendix B 2018 Guidance.docx Appendix B IC Document

Information Collection (IC) Details

IC Title:	Guidance	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2017-Tribal MIECHV Guidance for Submitting an Annual or Final Report to the Secretary FINAL FORMATTED.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	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	25	25
Annual IC Time Burden (Hours)	1,250	1,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix B	Appendix B 2018 Guidance.docx	04/12/2018

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