Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) On-Site Compliance Review Awardee Feedback Form

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB: 0915-0212

IC ID: 243729

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Document Name
Document Type
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Form
IC Document
Information Collection (IC) Details

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Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) On-Site Compliance Review Awardee Feedback Form
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 MIECHV On-Site Compliance Review Awardee Feedback Form.docx FORM MIECHV On-Site Compliance Review Awardee Feedback Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

165 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 165 0 0 0 0 165
Annual IC Time Burden (Hours) 41 0 0 0 0 41
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A MIECHV Compliance Supporting Statement A MIECHV Compliance.docx 09/22/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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