Information Collection

Refugee Health Promotion Data Indicators

IC 229119 under ICR 201807-0970-004 · OMB 0970-0490.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0490 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
RHP Data Indicator Form User Guide.docx	Instruction
1 RHP Program Data Indicators Form RHP Program Data Indicators Form.docx	Form
RHP_Template for PPR Gen IC.doc Justification	IC Document

IC Title:

Refugee Health Promotion Data Indicators

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			RHP Data Indicator Form User Guide.docx		Yes	Yes	Fillable Printable
Form	1	RHP Program Data Indicators Form	RHP Program Data Indicators Form.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: 41

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	41	41
Annual IC Time Burden (Hours)	123	123
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	RHP_Template for PPR Gen IC.doc	11/22/2017

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