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Information Collection

General Outreach Activities for Community Members Form

IC 248292 under ICR 202109-0906-002 · OMB 0906-0064.

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

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General Outreach Activities for Community Members Form
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 General Outreach Activities for Community Members Form Community Based Vaccine Outreach Program Reporting Module 07-07-2021.docx https://www.surveymonkey.com/r/ZTQDVBZ Yes Yes Fillable Fileable

Health Health Care Services

 

4,000,000 141
   
Private Sector 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 4,000,000 0 0 0 0 4,000,000
Annual IC Time Burden (Hours) 466,667 0 0 0 0 466,667
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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