Information Collection

District Level Administrator Interview

IC 213079 under ICR 201801-0920-007 · OMB 0920-1048.

Documents and Forms

Document Name Document Type
Att 9-CIIG-District-Level Admin.docx Other-Interview Guide

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	District Level Administrator Interview	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-Interview Guide			Att 9-CIIG-District-Level Admin.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2	1	1
Annual IC Time Burden (Hours)	2	1	1
Annual IC Cost Burden (Dollars)	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.