Information Collection

Annual Progress Report Instrument

IC 184866 under ICR 202009-0920-006 · OMB 0920-0106.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0106 can be found here:

Documents and Forms

Document Name Document Type
Annual Progress Report Instrument Form and Instruction
Annual Progress Report Instruments Att F_Annual Progress Report Instruments_081420.docx Form and Instruction
Annual Progress Report Instruments Att F_Annual Progress Report Instruments_081420.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Progress Report Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	none	Annual Progress Report Instruments	Att F_Annual Progress Report Instruments_081420.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 61	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	Previously Approved
Annual Number of Responses for this IC	61	0	61
Annual IC Time Burden (Hours)	671	-244	915
Annual IC Cost Burden (Dollars)	231,227	231,227	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.