Information Collection

Supportive Services for Tier 1 Grantees

IC 218692 under ICR 202309-0990-006 · OMB 0990-0438.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FY2020_TPP Performance Measures_supportiveservicesT1.docx	Other-Survey and instructions
FY2020_TPP Performance Measures_supportiveservicesT1.docx	Other-Survey and instructions

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey and instructions			FY2020_TPP Performance Measures_supportiveservicesT1.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 54

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	108	108
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.