Information Collection

Implementation Staff Interviews

IC 199921 under ICR 201110-0935-003 · OMB 0935-0190.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0190 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #2 Implementation Staff Interviews	Form and Instruction
Form #2 Implementation Satff Interview Guide Attachment C_ Implementation Staff Interview Guide.docx	Form and Instruction

IC Title:

Implementation Staff Interviews

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 #2	Implementation Satff Interview Guide	Attachment C_ Implementation Staff Interview Guide.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 288

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	288	288
Annual IC Time Burden (Hours)	288	288
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.