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Key Informant Interviews
Evaluation of the Text4baby Program
OMB: 0915-0347
IC ID: 200141
OMB.report
HHS/HSA
OMB 0915-0347
ICR 201208-0915-006
IC 200141
( )
Documents and Forms
Document Name
Document Type
Form 1
Key Informant Interviews
Form
1 Key Informant Interview Discussion Guide
Attachment E Key Informant Interview Discussion Guide May 2012.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Key Informant Interviews
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Form
1
Key Informant Interview Discussion Guide
Attachment E Key Informant Interview Discussion Guide May 2012.docx
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40
0
0
0
0
40
Annual IC Time Burden (Hours)
30
0
0
0
0
30
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
