Information Collection

Aim 1 Focus Group Screener and Topic Guide

IC 203729 under ICR 201309-0925-004 · OMB 0925-0669.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0669 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Aim 1 Focus Group Screener and Topic Guide	Form and Instruction
1 Focus Goup Topic Guide Q MSM_OMB_Attach_1_Focus_Goup_Topic_Guide_Q_17Dec2012_V_3_0.docx	Form and Instruction

IC Title:

Aim 1 Focus Group Screener and Topic Guide

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1	Focus Goup Topic Guide Q	MSM_OMB_Attach_1_Focus_Goup_Topic_Guide_Q_17Dec2012_V_3_0.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	96	96
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.