Interview Guide for Age Friendly Initiative Staff

Examining how Local Health Departments Leverage Age-Friendly Cities Initiatives to Build Resilience in Elderly Populations

Documents and Forms

Document Name Document Type
Attachment_D_Interview_Guide_AFI_Staff.docx Instruction
Attachment_G_Recruitment_Letter_for_AFI Staff.docx Recruitment Letter for AFI Staff IC Document

Information Collection (IC) Details

IC Title:	Interview Guide for Age Friendly Initiative Staff	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
Instruction			Attachment_D_Interview_Guide_AFI_Staff.docx		Yes	No	Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment Letter for AFI Staff	Attachment_G_Recruitment_Letter_for_AFI Staff.docx	07/29/2015

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