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Federal forms, ICRs, and supporting documents

Information Collection

Pay for Outcomes Workplan Timeline Template

IC 247312 under ICR 202105-0906-001 · OMB 0906-0063.

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

View Information Collection (IC)

Pay for Outcomes Workplan Timeline Template
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 FORM - PFO Workplan Timeline Template.xlsx FORM - PFO Workplan Timeline Template.xlsx Yes Yes Fillable Fileable
Instruction FORM - PFO SIR Guidance.docx Yes Yes Fillable Fileable

Health Health Care Services

 

15 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 15 0 15 0 0 0
Annual IC Time Burden (Hours) 1,380 0 1,380 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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