Information Collection

Site Visit Preparation for Cancer Control Programs and Tobacco Control Programs

IC 199088 under ICR 201108-0920-013 · OMB 0920-0918.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 05_Site Visit Preparation Instructions.doc	Other-Guidance
Appendix 04_Introductory Email for Prep Call.doc Appendix 04_Introductory Email for Prep Call	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Other-Guidance			Appendix 05_Site Visit Preparation Instructions.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	14	14
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix 04_Introductory Email for Prep Call	Appendix 04_Introductory Email for Prep Call.doc	08/25/2011

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