Information Collection

Att. 3c_Key Informant Interview Guide

IC 222049 under ICR 202012-0920-011 · OMB 0920-1161.

Documents and Forms

Document Name Document Type
Att 3c Key Informant Interview Guide.doc Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att. 3c_Key Informant Interview Guide	Agency IC Tracking Number:	16LL

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Att 3c Key Informant Interview Guide.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	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.