Information Collection

Grantee Key Staff- Web Survey

IC 198670 under ICR 201404-0930-001 · OMB 0930-0340.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0340 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0371Attach 10 Web Survey.DOC	Other-survey

IC Title:

Grantee Key Staff- Web Survey

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-survey			0990-0371Attach 10 Web Survey.DOC		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 560

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	560	560
Annual IC Time Burden (Hours)	840	840
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.