Information Collection

Exploratory Focus Group with Selected Women

IC 195475 under ICR 201011-0920-009 · OMB 0920-0878.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment 4 Exploratory Focus Group with Selected Women	Form and Instruction
Attachment 4 Exploratory Focus Group with Women Selected Attachment 4_Exploratory Focus Group Discussion Guide_FINAL.DOCX	Form and Instruction

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
Form and Instruction	Attachment 4	Exploratory Focus Group with Women Selected	Attachment 4_Exploratory Focus Group Discussion Guide_FINAL.DOCX		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	144	144
Annual IC Cost Burden (Dollars)	1,512	1,512

Documents for IC

table that charts IC Documents
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.