Application Form

Million Hearts Hypertension Control Challenge

OMB: 0920-0976

IC ID: 206920

Information Collection (IC) Details

View Information Collection (IC)

Application Form 0920-0976
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0976 Application Form Attachment 3a. Revised Application Form 0920-0976.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

200 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 100 0 0 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Confirmation Email Attachment 3b. Confirmation email 0920-0976.docx 07/25/2019
Screenshots of Updated 2016 Web site Attachment 6 Screenshot 2019 Challenge 0920-0976.pdf 07/25/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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