Information Collection

Focus Group with AI/AN Community Members with Prior MI

IC 185918 under ICR 200807-0920-005 · OMB 0920-0797.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 5A. Discussion Guide MI Group.doc	Other-Focus Group Discussion Guide f
Att 5B. Supplement for Discussion Guide MI Group.doc Supplement for MI Discussion Group	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Discussion Guide for Prior MI			Att 5A. Discussion Guide MI Group.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supplement for MI Discussion Group	Att 5B. Supplement for Discussion Guide MI Group.doc	07/16/2008

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