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The Pregnancy Assistance Fund (PAF) Performance, FY2017-FY2019, revised for cohort 5
OMB: 0990-0460
IC ID: 226859
OMB.report
HHS/HHSDM
OMB 0990-0460
ICR 201812-0990-003
IC 226859
( )
Documents and Forms
Document Name
Document Type
PAF grantee form_training 0990_0460rev12212018.doc
Other-survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Training Forms
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-survey
PAF grantee form_training 0990_0460rev12212018.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
23
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 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
23
0
4
0
0
19
Annual IC Time Burden (Hours)
6
0
1
0
0
5
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.