SQI Telephone Interview

Evaluation of Core Violence and Injury Prevention Program

OMB: 0920-0916

IC ID: 210099

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SQI Telephone Interview
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-PDF Attachment J - SQI Telephone Interviews.pdf Yes Yes Fillable Printable

Health Immunization Management

 

4 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4 0 4 0 0 0
Annual IC Time Burden (Hours) 4 0 4 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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