Information Collection

Annual Program Performance Report

IC 7549 under ICR 202607-0930-003 · OMB 0930-0169.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PAIMI PPR PAIMI PPR Annual Program Performance Report	Form and Instruction
Form PAIMI PPR Instruct PAIMI PPR Instructions Annual Program Performance Report	Form and Instruction
PAIMI PPR PAIMI PPR 0930-0169FY 2026_PAIMI _PPR.docx	Form and Instruction
PAIMI PPR Instruct PAIMI PPR Instructions 0930-0169FY2026_ PAIMI _PPR_Instructions.docx	Form and Instruction
0169 PAIMI _PPR_ Mark-up - 5.24.2023.docx 0169 PAIMI _PPR_ Mark-up	IC Document
0169 PAIMI _PPR_Instructions_Mark-up - 5.24.2023.docx 0169 PAIMI _PPR Instructions _ Mark-up	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	PAIMI PPR				Yes	Yes	Fillable Fileable
Form and Instruction	PAIMI PPR Instructions				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 57

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	1,140	1,140
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0169 PAIMI _PPR_ Mark-up		06/22/2023
0169 PAIMI _PPR Instructions _ Mark-up		06/22/2023

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

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