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IDI Guide for Program Managers
Case Studies to Explore Interventions to Support, Build, and Provide Legacy Awareness for Young Breast Cancer Survivors
OMB: 0920-1012
IC ID: 210404
OMB.report
HHS/CDC
OMB 0920-1012
ICR 201402-0920-013
IC 210404
( )
Documents and Forms
Document Name
Document Type
Att 10b_IDI Funded Program Managers_9.11.13.docx
Other-WORD
Att 11b_IDI Nonfunded Program Managers_9.11.13.docx
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Information Collection (IC) Details
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IC Title:
IDI Guide for Program Managers
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
Other-WORD
Att 10b_IDI Funded Program Managers_9.11.13.docx
No
No
Fillable Fileable
Other-WORD
Att 11b_IDI Nonfunded Program Managers_9.11.13.docx
No
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
5
0
5
0
0
0
Annual IC Time Burden (Hours)
5
0
5
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.