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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.