Information Collection

6: Quarterly Performance Report (QPR)

IC 246011 under ICR 202102-0970-014 · OMB 0970-0566.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0566 can be found here:

Documents and Forms

Document Name Document Type
Form HM 6: Quarterly Performance Report (QPR) Form and Instruction
HM HM QPR Attachment J_Instrument 6HM_QPR.docx Form and Instruction
HM HM QPR Attachment J_Instrument 6HM_QPR_030321.docx Form and Instruction
RF RF QPR Attachment J_Instrument 6RF_QPR.docx Form and Instruction
RF RF QPR Attachment J_Instrument 6RF_QPR_updated 030321.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	6: Quarterly Performance Report (QPR)	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
Form and Instruction	HM	HM QPR	Attachment J_Instrument 6HM_QPR_030321.docx		Yes	Yes	Fillable Fileable
Form and Instruction	RF	RF QPR	Attachment J_Instrument 6RF_QPR_updated 030321.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 136	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	272	272
Annual IC Time Burden (Hours)	272	272
Annual IC Cost Burden (Dollars)	0	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.