Revised Performance Measure

Maternal and Child Health Bureau Performance Measures for Discretionary Grant Information System (DGIS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0298 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Revised Performance Measure Form and Instruction
Form 1 Revised Performance Measure Form and Instruction
1 Training 15 Performance Measure with Proposed Revisions Training 15 PERFORMANCE MEASURE_revised.docx Form and Instruction
1 Training 15 Performance Measure with Proposed Revisions Training 15 PERFORMANCE MEASURE_revised.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Revised Performance Measure	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Training 15 Performance Measure with Proposed Revisions	Training 15 PERFORMANCE MEASURE_revised.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 700	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	25,200	25,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.