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Tribal Maternal, Infant, and Early Childhood Home Visiting Performance Reporting Form

IC 226874 under ICR 202210-0970-002 · OMB 0970-0500.

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Information Collection (IC) Details

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Tribal Maternal, Infant, and Early Childhood Home Visiting Performance Reporting Form
 
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 2 Tribal MIECHV Reporting Form 2 Tribal Home Visiting Form 2.docx Yes Yes Fillable Fileable
Instruction Tribal MIECHV Performance Measures.docx Yes Yes Printable Only

Community and Social Services Social Services

 

23 0
   
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 23 0 0 0 0 23
Annual IC Time Burden (Hours) 11,500 0 0 0 0 11,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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