Information Collection

Focus Groups with Senior Center Staff/Administrators

IC 198902 under ICR 201103-0925-005 · OMB 0925-0634.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Focus Groups with Senior Center Staff/Administrators	Form
1 Pre questionaire NIA pre-focus group questionnaire-2.docx	Form
2 questionaire NIA Focus Group Question Guide-2.docx	Form
senior center focus group generic_clearance_form-3.doc senior center focus group generic_clearance_form-3	IC Document
NIA mini supporting to omb--senior center project-2.doc NIA mini supporting to omb--senior center project-2	IC Document

IC Title:

Agency IC Tracking Number:

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	1	Pre questionaire	NIA pre-focus group questionnaire-2.docx		Yes	Yes	Fillable Fileable
Form	2	questionaire	NIA Focus Group Question Guide-2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 54

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 New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	54	0	0	0	0	0
Annual IC Time Burden (Hours)	45	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
senior center focus group generic_clearance_form-3	senior center focus group generic_clearance_form-3.doc	08/12/2011
NIA mini supporting to omb--senior center project-2	NIA mini supporting to omb--senior center project-2.doc	08/12/2011

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