Information Collection

Client Group (qualitative In-depth interview)

IC 208916 under ICR 201311-0925-003 · OMB 0925-0688.

Documents and Forms

Document Name Document Type
Form 3 Client Group (qualitative In-depth interview) Form and Instruction
3 In-depth Interview Attachment 4 Client In-depth Interview Guide.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Client Group (qualitative In-depth interview)	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	3	In-depth Interview	Attachment 4 Client In-depth Interview Guide.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	1	1
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.