Attachment D

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

OMB: 0915-0298

IC ID: 261604

Information Collection (IC) Details

View Information Collection (IC)

Attachment D
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 Attachment D Additional Data Elements DGIS OMB_SSA_Attachment D_Additional Data Elements_CLEAN_HS Site Form Update.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

578 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 578 0 0 0 0 578
Annual IC Time Burden (Hours) 1,463 0 0 0 0 1,463
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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