Information Collection

Performance Monitoring Questions

IC 267198 under ICR 202404-0920-007 · OMB 0920-1435.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Performance Monitoring Questions	Form and Instruction
Performance Monitoring Questions Att3_Data collection instrument_monitoring questions guide_RTIClean.docx	Form and Instruction
Performance Monitoring Questions Att3_Data collection instrument_monitoring questions guide_RTIClean.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-24CR

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form and Instruction	n/a	Performance Monitoring Questions	Att3_Data collection instrument_monitoring questions guide_RTIClean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	64	64
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.