OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Program Facilitators- Fidelity log

IC 248508 under ICR 202207-0990-004 · OMB 0990-0480.

Documents and Forms
Document Name
Document Type
Other-instruction and log
Other-instruction and log
Information Collection (IC) Details

View Information Collection (IC)

Program Facilitators- Fidelity log
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-instruction and log Instrument 4_Fidelity Log832021.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

13 0
   
Individuals or Households
 
   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 312 0 0 0 0 312
Annual IC Time Burden (Hours) 52 0 0 0 0 52
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.