OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

SMaRT App Install

IC 262652 under ICR 202504-0920-010 · OMB 0920-1421.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

SMaRT App Install 0920-25-0073
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a SMART App Installation Att 4d_SMaRT app installation English.docx Yes Yes Fillable Fileable
Form and Instruction n/a SMART App Installation (Spanish) Att 4d_SMaRT app installation Spanish.docx Yes Yes Fillable Fileable
Form 0920-25-0073 Behavioral_Assessment_HET_Spanish Att 4d_Behavioral_Assessment_HET_Span_clean.docx Yes Yes Fillable Fileable
Form 0920-25-0073 Behavioral_Assessment_HET_English Att 3d_Behavioral_Assessment_HET_Eng_clean.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

425 0
   
Individuals or Households
 
   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 425 0 0 0 0 425
Annual IC Time Burden (Hours) 71 0 0 0 0 71
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.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].