Information Collection

IMAT Grantee Interview

IC 215626 under ICR 201503-0925-003 · OMB 0925-0720.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0720 can be found here:

Documents and Forms

Document Name Document Type
Form 1 IMAT Grantee Interview Form and Instruction
1 IMAT Interview Guide Attachment 1_IMAT Interview Guide_02-20-15.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	IMAT Grantee Interview	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
Form and Instruction	1	IMAT Interview Guide	Attachment 1_IMAT Interview Guide_02-20-15.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.