Information Collection

CCC Staff Key Informant Interview Guide

IC 210387 under ICR 201402-0920-012 · OMB 0920-1016.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1016 can be found here:

Documents and Forms

Document Name Document Type
Att D1_Key_Informant_Interview_11_01_13.docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CCC Staff Key Informant Interview Guide	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
Instruction			Att D1_Key_Informant_Interview_11_01_13.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.