Information Collection

Stakeholders: employers and payers (In-depth interview)

IC 197790 under ICR 201105-0990-004 · OMB 0990-0381.

Documents and Forms

Document Name Document Type
0990-CER_Portfolio_I - SSLA-Employers_and_Payers_Interview_Protocol (5-6-11).docx Other-survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Stakeholders: employers and payers (In-depth interview)	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
Other-survey			0990-CER_Portfolio_I - SSLA-Employers_and_Payers_Interview_Protocol (5-6-11).docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	10	10
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.