Information Collection

CCC Staff Key Informant Selection

IC 210384 under ICR 201510-0920-001 · OMB 0920-1016.

Documents and Forms

Document Name Document Type
Form 0920- CCC Staff Key Informant Selection Form and Instruction
0920- Att D3_Key_Informant_Selection_10_29_13 Att D3_Key_Informant_Selection_10_29_13.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CCC Staff Key Informant Selection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	0920-	Att D3_Key_Informant_Selection_10_29_13	Att D3_Key_Informant_Selection_10_29_13.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	16	16
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.