Information Collection

Core VIPP Funded SHD: Telephone Interview

IC 200345 under ICR 201302-0920-012 · OMB 0920-0916.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0916 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment D_Telephone interviews.docx	Other-Telephone interview questions

IC Title:

Core VIPP Funded SHD: Telephone Interview

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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-Telephone interview questions for Core VIPP Evaluation					Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 28

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	42	42
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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