Information Collection Request

The Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report

ICR 202110-0906-001 · OMB 0906-0016 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report Form and Instruction Modified Repair queued
Attachment B_60 Day FRN_Form 4 Revision.pdf Supplementary Document Uploaded 2021-10-04 Missing upstream
Supporting Statement A 0906-0016 Revision.docx Supporting Statement A Uploaded 2021-10-04 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
218304 Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 02/28/2022
488 264
18,752 13,376
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report 1 MIECHV Form 4 Revised CLEAN.docx

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 488 264 0 224 0 0
Annual Time Burden (Hours) 18,752 13,376 0 5,376 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No