Application Form

[NCCDPHP] Million Hearts Hypertension Control Challenge

OMB: 0920-0976

IC ID: 206920

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

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Application Form 0920-0976
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0976 Application Form Attachment 3a. MH Hypertension Control Challenge Application_12.11.25.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

100 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 100 0 -100 0 0 200
Annual IC Time Burden (Hours) 50 0 -50 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Confirmation Email Attachment 3b. Confirmation email 0920-0976.docx 09/29/2022
Screenshots of Updated 2016 Web site Attachment 6 Screenshot of application.pdf 09/29/2022
Confirmation Email Attachment 3b. Confirmation email 0920-0976.docx 01/29/2026
Screenshot of Champions Attachment 6. Screenshot of Champions Application_2025.jpeg 01/29/2026
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