Information Collection

Initial population - Annual reporting - Progress Report Tool

IC 222746 under ICR 201607-0920-014 · OMB 0920-1155.

Documents and Forms

Document Name Document Type
Initial population - Annual reporting - Progress Report Tool Form and Instruction
Initial population - Annual reporting - Progress Report Att. 3a APR Year 1.xlsm Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Initial population - Annual reporting - Progress Report Tool	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Initial population - Annual reporting - Progress Report Tool	Att. 3a APR Year 1.xlsm	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 29	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	29	29
Annual IC Time Burden (Hours)	580	580
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.