Information Collection

SSG Fox SPGP - Annual Grantee Performance Report

IC 253133 under ICR 202601-2900-003 · OMB 2900-0904.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-316a SSG Fox SPGP - Annual Grantee Performance Report SSG Fox SPGP - Annual Grantee Performance Report	Form
10-316a SSG Fox SPGP - Annual Grantee Performance Report VA Form 10-316a.pdf	Form

IC Title:

Agency IC Tracking Number:

2900-0904

Is this a Common Form? No

IC Status: Removed

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	10-316a				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-90	90
Annual IC Time Burden (Hours)	-68	68
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.

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