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Federal forms, ICRs, and supporting documents

Information Collection

BHW Performance Measures Forms

IC 206385 under ICR 202603-0906-004 · OMB 0906-0086.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Other-Program Mapping Document
Other-Program Mapping Document
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

BHW Performance Measures Forms
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 Performance Measures 0906-0086_Appendix C - Performance Measures - BHW Updates - 4.17.26.docx Yes Yes Fillable Fileable
Other-Program Mapping Document 0906-0086_Appendix C - Mapping Document - BHW Updates - 4.17.26.docx Yes Yes Fillable Fileable
Form and Instruction 1 Progress Report Appendix B - Progress Report.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,968 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 1,968 0 86 0 0 1,882
Annual IC Time Burden (Hours) 5,657 0 -272 0 0 5,929
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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