Information Collection Request

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

ICR 202308-0915-004 · OMB 0915-0298 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 Attachment D Additional Data Elements Form and Instruction New Available
Form 3 Attachment D Form and Instruction New Repair queued
Form 2 Attachment C Program Specific Form Form and Instruction New Repair queued
Form 2 Attachment C Program Specific Form Form and Instruction New Repair queued
Form 1 Attachment B DGIS OMB Form and Instruction New Available
Form 1 Attachment B Central Forms Form and Instruction New Repair queued
Form 1 Training 15 Performance Measure with Proposed Revisions Form and Instruction Removed Available
Form 1 Revised Performance Measure Form and Instruction Removed Repair queued
DGIS OMB_Supporting Statement A_CLEAN Rev. Table.docx Supporting Statement A Uploaded 2023-08-18 Available
DGIS OMB_Attachment B1_Crosswalk of Changes_DGIS_CLEAN.pdf Supplementary Document Uploaded 2023-08-17 Repair queued
Attachment F - Summary of Public Comments.docx Supplementary Document Uploaded 2022-08-23 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
261604 Attachment D Form and Instruction NewAttachment D Additional Data Elements
261604 Attachment D Form and Instruction New
261602 Attachment C Program Specific Form Form and Instruction NewAttachment C Program Specific Form
261602 Attachment C Program Specific Form Form and Instruction New
261600 Attachment B Central Forms Form and Instruction NewAttachment B DGIS OMB
261600 Attachment B Central Forms Form and Instruction New
256606 Revised Performance Measure Form and Instruction RemovedTraining 15 Performance Measure with Proposed Revisions
256606 Revised Performance Measure Form and Instruction Removed
254635 Grant Report Other-Reporting Requirement/Performance Measure Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2026 36 Months From Approved 08/31/2025
9,239 0 1,400
17,615 0 50,400
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Attachment B Central Forms 1
Attachment C Program Specific Form 2
Attachment D 3
Grant Report
Revised Performance Measure 1

table that charts list of burden
  Total Approved 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 9,239 1,400 0 9,239 -1,400 0
Annual Time Burden (Hours) 17,615 50,400 0 17,615 -50,400 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No