Information Collection

Staff and community member interview (Master Topic Guide)

IC 195398 under ICR 201011-0990-007 · OMB 0990-0375.

Documents and Forms

Document Name Document Type
0990-PPA_Staff Comm Member Interviews - Master Topic Guide.doc Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Staff and community member interview (Master Topic 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			0990-PPA_Staff Comm Member Interviews - Master Topic Guide.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	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
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	72	72
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.