Information Collection

User Insights for NCHHSTP Atlas Website and Tool Review- Interviews

IC 219430 under ICR 201407-0920-003 · OMB 0920-1027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
User Insights for NCHHSTP Atlas Website and Tool Review- Interviews	Form and Instruction
Facilitator Script Interview Att1-FacilitatorScript-Interview Final.docx	Form and Instruction
NCHHSTP Atlas_FastTrackSubmission ShortForm-Interviews.docx Fast Track GenIC Request	IC Document

IC Title:

User Insights for NCHHSTP Atlas Website and Tool Review- Interviews

Agency IC Tracking Number:

16IP

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
Form and Instruction	NA	Facilitator Script Interview	Att1-FacilitatorScript-Interview Final.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track GenIC Request	NCHHSTP Atlas_FastTrackSubmission ShortForm-Interviews.docx	12/30/2015

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