Attachment C Program Specific Form

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

OMB: 0915-0298

IC ID: 261602

Information Collection (IC) Details

View Information Collection (IC)

Attachment C Program Specific Form
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 Attachment C Program Specific Form DGIS OMB_SSA_Attachment C_Program Specific Forms_CLEAN HS11 update 07062023.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

2,019 0
   
Private Sector Businesses or other for-profits, 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 2,019 0 0 0 0 2,019
Annual IC Time Burden (Hours) 1,376 0 0 0 0 1,376
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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