Information Collection

In-Person Interviews

IC 195902 under ICR 201101-0930-002 · OMB 0930-0322.

Documents and Forms

Document Name Document Type
Form Interviews and sur In-Person Interviews Form and Instruction
Interviews and sur Interviews and survey-instruments Interviews and Survey Instruments.pdf Form and Instruction
In-person training In-person training material-instruments In Person Training Material-Instruments.pdf Form and Instruction
Interviews and Survey-Other.pdf Interviews and Survey-Other IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	In-Person Interviews	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
Form and Instruction	Interviews and survey-instruments	Interviews and survey-instruments	Interviews and Survey Instruments.pdf		Yes	Yes	Paper Only
Form and Instruction	In-person training material-instruments	In-person training material-instruments	In Person Training Material-Instruments.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	61	61
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Interviews and Survey-Other	Interviews and Survey-Other.pdf	04/07/2011

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