Information Collection

Interview Guide for State Environmental Health Professionals

IC 209792 under ICR 201312-0923-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att8_Int_Guide.doc	Other-WORD
Att12_FocGrps_Scrn_Shots.pptx Att12_FocGrps_Scrn_Shots	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Other-WORD			Att8_Int_Guide.doc		Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att12_FocGrps_Scrn_Shots	Att12_FocGrps_Scrn_Shots.pptx	12/16/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.