OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

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

IC 218304 under ICR 202110-0906-001 · OMB 0906-0016.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Tracked Changes
Other-Tracked Changes
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report
 
No Modified
 
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 1 MIECHV Form 4 Revised CLEAN.docx Attachment A _MIECHV Form 4 Revised CLEAN.docx Yes Yes Fillable Fileable
Other-Tracked Changes Attachment A _MIECHV Form 4 TRACKED.docx Yes Yes Fillable Fileable
Form and Instruction 1 Updated Attachment A _MIECHV Form 4 Revised Updates 11-22-21.docx Attachment A _MIECHV Form 4 Revised_updates.docx Yes Yes Fillable Fileable

Health Health Care Services

 

56 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 488 0 224 0 0 264
Annual IC Time Burden (Hours) 18,752 0 5,376 0 0 13,376
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.