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Federal forms, ICRs, and supporting documents

Information Collection

Instrument 4 - Provider photo journals

IC 260159 under ICR 202312-0970-009 · OMB 0970-0612.

Documents and Forms
Document Name
Document Type
Other-photo journals
Other-photo journals
Other-photo journals - Spanish
Other-photo journals - Spanish
Information Collection (IC) Details

View Information Collection (IC)

Instrument 4 - Provider photo journals
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-photo journals Instrument 4. Provider photo journals_30day.docx Yes Yes Fillable Fileable
Other-photo journals - Spanish Instrument 4. Provider photo journals_Spanish.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

60 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 480 0 0 0 0 480
Annual IC Time Burden (Hours) 48 0 0 0 0 48
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.