OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Quarterly Health Center Perfoemance Measure Reporting Tool

IC 222375 under ICR 201912-0920-012 · OMB 0920-1156.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Quarterly Health Center Perfoemance Measure Reporting Tool
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1156 Quarterly Health Center Performance Measure Reporting Tool Online Att 5b Quarterly Health Center Performance Measure Reporting Tool Online Version.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1156 Quarterly Health Center Performance Measure Reporting Tool Att 5a Quarterly Health Center Performance Measure Reporting Tool final.docx NA Yes Yes Fillable Fileable

Health Health Care Services

 

4 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 8 0 -4 0 0 12
Annual IC Time Burden (Hours) 32 0 -16 0 0 48
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.