OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Tribal Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report

ICR 201811-0970-011 · OMB 0970-0525 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Tribal MIECHV Quarterly Reporting Form Form and Instruction New Available
TMIECHV Form 4 Supporting Statement.doc.docx Supporting Statement A Uploaded 2018-11-26 Available
IC Document Collections
IC IDCollectionTypeStatusForm
234135 Tribal MIECHV Quarterly Reporting Form Form and Instruction New
ICR Details
0970-0525 201811-0970-011
Active
HHS/ACF OCC
Tribal Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 03/15/2019
Retrieve Notice of Action (NOA) 11/27/2018
  Inventory as of this Action Requested Previously Approved
03/31/2022 36 Months From Approved
100 0 0
2,400 0 0
0 0 0
This report is used to measure program performance.
None
None
Not associated with rulemaking
  83 FR 45603 09/10/2018
83 FR 58574 11/20/2018
No
1
IC Title Form No. Form Name
Tribal MIECHV Quarterly Reporting Form 1 Attachment 1
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 0 0 100 0 0
Annual Time Burden (Hours) 2,400 0 0 2,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New ICR
$84,990
No
    No
    No
No
No
No
Uncollected
Robert Sargis 202 690-7275 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/27/2018