Information Collection

Semi-structured interviews

IC 197288 under ICR 201104-0935-005 · OMB 0935-0180.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #1 Semi-structured interviews	Form and Instruction
Form #1 Key Informant Interview Guide Attachment B -- Key Informant Interview Guide.docx	Form and Instruction
Attachment C -- Invitation Letter.doc Attachment C -- Invitation Letter	IC Document
Attachment D -- Confirmation Letter.docx Attachment D -- Confirmation Letter	IC Document
Attachment E -- Thank You Letter.doc Attachment E -- Thank You Letter	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
Form and Instruction	Form #1	Key Informant Interview Guide	Attachment B -- Key Informant Interview Guide.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	15	15
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment C -- Invitation Letter	Attachment C -- Invitation Letter.doc	04/04/2011
Attachment D -- Confirmation Letter	Attachment D -- Confirmation Letter.docx	04/04/2011
Attachment E -- Thank You Letter	Attachment E -- Thank You Letter.doc	04/04/2011

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