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#17 - 71112
ICR 202610-0938-013 · OMB 0938-1148 · Object 174259000.
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Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | #17 - 71112 |
| Author | Erika Durant |
| Last Modified By | Acrobat PDFMaker 26 for Word |
| File Modified | 2026-06-16 |
| File Created | 2026-06-16 |
| Conversion State | complete |
Extracted Text
Screenshots for CS22 Template – UPDATED* Update – to include “State Name” dropdown and “Transmittal Number” Update – State drop-down list 1 State drop-down list with selection; Targeted Low-Income Children w/ “Other” selected 2 Targeted Low-Income Pregnant Women w/ “Other” selected From-Conception-to-End-of-Pregnancy (FCEP) w/ “Other” selected 3