Information Collection

Moderator"s Guide

IC 202106 under ICR 201204-0990-004 · OMB 0990-0400.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1.REVISED.ATTACHMENT E1_ELE Focus Group Moderator Guide and Script.doc	Other-REVISED.ATTACHMENT E1_ELE Focu
2.REVISED.ATTACHMENT E2_Non-ELE Focus Group Moderator Guide.doc	Other-REVISED.ATTACHMENT E2_Non-ELE

IC Title:

Moderator"s Guide

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
Other-REVISED.ATTACHMENT E1_ELE Focus Group Moderator Guide and Script.doc					No		Printable Only
Other-REVISED.ATTACHMENT E2_Non-ELE Focus Group Moderator					No		Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

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	240	240
Annual IC Time Burden (Hours)	480	480
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.

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