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Hv-bat
Maternal, Infant, and Early Childhood Home Visiting Program: Cost Reporting Tool for Pilot Test in Select Local Implementing Agencies
OMB: 0906-0025
IC ID: 258858
OMB.report
HHS/HRSA
OMB 0906-0025
ICR 202303-0906-001
IC 258858
( )
Documents and Forms
Document Name
Document Type
Form 1
HV-BAT
Form and Instruction
1 Maternal, Infant and Early Childhood Home Visiting Progr
Appendix A - HV-BAT.xlsx
Form and Instruction
1 Maternal, Infant and Early Childhood Home Visiting Progr
Appendix A - HV-BAT.xlsx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
HV-BAT
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
Form and Instruction
1
Maternal, Infant and Early Childhood Home Visiting Program Home Visiting Budget Assistance Tool
Appendix A - HV-BAT.xlsx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
19
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
247
0
247
0
0
0
Annual IC Time Burden (Hours)
9,880
0
9,880
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.