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_HRSA RWHAP COVID-19 Data Report

IC 241923 under ICR 202011-0906-001 · OMB 0906-0053.

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_HRSA RWHAP COVID-19 Data Report
 
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 1 Coronavirus 2019 (COVID-19) Data Report Form.docx Coronavirus 2019 (COVID-19) Data Report Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

2,045 0
   
State, Local, and Tribal Governments
 
   100 %

  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 24,540 0 0 0 0 24,540
Annual IC Time Burden (Hours) 78,528 0 29,448 0 0 49,080
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment B - 2020_CDR_Instruction_Manual_08_03_20_508 Attachment B - 2020_CDR_Instruction_Manual_08_03_20_508.pdf 11/15/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.